自体骨髓干细胞移植治疗失代偿肝硬化临床观察

Treatment of Decompensated Liver Cirrhosis by Autologous Bone Marrow Transplation

目的探讨自体骨髓干细胞移植治疗失代偿肝硬化的临床疗效。方法选择12例失代偿期乙肝后肝硬化患者,年龄38～75岁。患者在无菌条件下,从髂后上棘抽取骨髓80～90ml,分离纯化骨髓干细胞,经肝动脉导管注入肝脏。术后定期检测肝功能和凝血功能,并观察临床症状及不良反应情况。结果与术前相比,术后1周所有血清学指标均无显著性改变(P>0.05);术后4周,白蛋白、前白蛋白及胆碱酯酶活性显著性升高(P<0.01,P<0.05),余肝功能和凝血功能指标均无明显变化(P>0.05)。术后1周患者乏力、腹胀开始减轻,食欲好转,术后4周腹水减轻。术中有1例因紧张进食少出现低血糖,经治疗后好转,余均未发现皮疹、发热、抽搐及出血等其它不良反应及并发症。结论自体骨髓干细胞移植治疗后,患者肝功能明显改善,症状好转,表明骨髓干细胞移植对肝衰竭患者的治疗安全有效且不良反应少。

Objective To investigate the effect of autologous bone marrow transplantation in the treatment of patients with liver failure.Methods Bone marrow was harvested（80-90ml） from 12 patients.In order to get the bone marrow stem cells（BMSCs）,bone marrow was processed by density gradient sedimentation,the final preparation of BMSCs were infused into liver of patients via liver artery.At the different time（1 week,4 week） after transplantation,the indexes of liver function and blood clotting function were measured,and the symptoms as well as adverse effects were recorded. Results All the serum biochemical indexes were no changed at 1 week after transplantation （ P 〉 0.05 ）. Comparing with pre - transplantation, the levels of albumin （ ALB）, pre - albumin （AP） and cholinesterase （CHE） were significantly elevated at 4 week after transplantation （P 〈 0. 01 ,P 〈 0. 05）. And the other indexes were no statistical significance （P 〉 0.05） . At 1 week after transplantation,improved appetite was observed. The symptoms of abdominal dropsy were decreased at 4 week after transplantation. Besides of one case happened hypoglycemia, the others patients had no obvious adverse effects. Conclusion BMSCs transplantation can significantly improve the liver function of patients with terminal liver disease.