人脐带干细胞外周静脉移植治疗失代偿期肝硬化的临床疗效

Therapeutic Effect of Human Umbilical Cord Cells Transplantation via Peripheral Veins in Patients with Decompensated Cirrhosis

目的:探讨人脐带间充质干细胞(HUCMSCs)移植治疗失代偿期肝硬化的临床效果。方法:20例肝硬化失代偿期患者,采用人脐带血干细胞移植治疗,移植术后3 d,7 d,14 d、4周,8周,12周观察血清转氨酶(ALT)、总胆红素(TB)、凝血酶原时间(PT)和白蛋白(ALB)水平变化,同时观察临床症状的改善情况。结果:术后3,7 d,各项肝功能指标无显著性差异(P>0.05),术后14 d、4周,除外ALT有所改善(P<0.05),其余指标无明显改善,8周各项肝功能指标均有改善(P<0.05)。12周有显著的改善(P<0.01),腹水减轻75.0%(15/20),乏力好转占80%(16/20)。食欲改善者占65%(13/20),移植术中和术后未见明显不良反应。结论:HUCMSCs体外培养诱导、扩充后外周静脉移植是治疗失代偿期肝硬化一种安全有效的方法,可以显著改善失代偿期肝硬化患者肝功能及临床症状。

Objective： To investigate the clinical effect of human umbilical cord mesenchymal stem cells（HUCMSCs） transplantation via peripheral veins in the treatment of decompensated cirrhosis.Methods： Twenty patients who had decompensated cirrhosis received transplantion of HUCMSCs.The levels of serum alanine aminotransferase（ALT）,total bilirubin（TB）,prothrombin time（PT）,and albumin（ALB） were examined before transplantation and 3 days,1,2and 4,8, 12 weeks after transplantation.Simultaneously,the improvement in clinic syndromes was observed after transplantation.Methods： The indexes of liver function did not show remarkably changes in 4 weeks after transplantation（P〉0.05）,except ALT in 2 and 4 weeks after transplantation（P〈0.05）. Significant improvement in liver function indexes was found after 8 weeks（P〈0.05） and after 12 weeks（P〈0.01）.Twelve weeks after transplantation,ascite was relieved in 15 patients（75%）.Debility and appetite were improved in 16 patients（80%） and 13 patients（65%） respectively.No patient developed severe complications and adverse reactions associated with transplantation.Conclusion： Culture in vitro and extension transplantation of HUCMSCs via peripheral veins is a safe and effective way of treatment,and it can improve significantly the indexes of liver function and clinical symptoms in the patients with decompensated cirrhosis.