自体骨髓干细胞移植治疗肝功能不全的临床研究

Therapeutic effect of autologous bone marrow stem cell transplantation in the treatment of severe liver damage

目的探索自体骨髓干细胞移植对肝功能不全患者的治疗效果,为干细胞移植的临床大规模开展提供基础。方法 6例肝功能不全患者均来源于我所住院患者,年龄44～69岁;患者在无菌条件下,从骼后上棘抽取骨髓50ml,分离纯化骨髓干细胞。在局部麻醉下,行肝动脉介入将分离的骨髓干细胞移植于肝脏;患者在移植后不同时间,1、2、4、8、12周进行肝功能检测;观察在移植后不同时间症状改善情况及术后的不良反应情况。结果移植后,谷丙转氨酶逐渐降低,由平均98.4IU/L降至41.5IU/L,总胆红素由平均136.5μmol/L降至78.4μmol/L,肌酐由112.3μmol/L降至72.1μmol/L;白蛋白逐渐升高,由平均23.3g/L升至32.6g/L;凝血酶原时间下降不明显。患者在移植12周生存率为100%,1例在7个月后死亡。移植后大多数患者症状明显改变,移植后12周食欲改善3例,精神体力好转3例,腹胀减轻2例。在4例随访患者中未发现严重并发症,术后有轻度恶心1例,发热1例,经对症治疗后好转,未见其他严重不良反应。结论自体骨髓干细胞移植治疗后,患者肝功能逐步改善,症状好转,表明骨髓干细胞移植对肝功能不全患者的治疗有效且副作用小,安全。

Objective To evaluate the effect of autologous bone marrow stem cell transplantation in the treatment of severe liver damage. Methods Autologous bone marrow （50 ml） was harvested from 6 patients aged 44 to 69 years admitted for severe liver damage. Human bone marrow stem cells （HMSCs） were isolated and transplanted in to the patients＇ liver. At l,4,8,and 12 weeks after the transplantation,the changes in ALT,ALB,Cr,TB,PT and the clinical symptoms of the patients were observed. Results The transplantation of qutologous bone marrow stem cells resulted in obvious improvement of the liver function. At 12 weeks after the transplantation,ALT was reduced from 98.4 IU/L to 41.5 IU/L,TB from 136.5 μmol/L to 78.4 μmol/L,Cr from 112.3 μmol/L to 72.1 μmol/L,and ALB rose from 23.3 g/L to 32.6 g/L. The survival of the patients was 100% at 12 weeks,but one patient died at 7 months after the transplantation. The symptoms of the patients were also alleviated after the transplantation. At 12 weeks after transplantation,3 patients reported improved appetite,3 showed recovery of physical strength,and 2 showed lessened abdominal swelling. No serious adverse complications in association with the transplantation were found in the in 4 patients available to the follow-up. Conclusion Autologous bone marrow stem cell transplantation can improve the liver function of patients with severe liver damage without causing serious complications.