骨髓干细胞原位移植治疗失代偿期乙型肝炎肝硬化

A Clinical Study on Treatment of Decompensate Type B Hepatitis Cirrhosis Patients with Bone Marrow Stem Cell Orthotopic Transplantation

目的:应用重组人集落刺激因子动员失代偿期乙型肝炎肝硬化患者骨髓干细胞释放进入血液循环,观察患者肝功能指标变化情况。方法:患者入选标准为失代偿期乙型肝炎肝硬化患者、核苷类似物抗乙肝病毒治疗后连续3个月肝功能指标不再改善者,入选病例132例,随机分为治疗组(66例)和对照组(66例),两组均应用核苷类似物抗病毒治疗;治疗组连续5 d注射重组人集落刺激因子300μg,每日1次,分别于12周、24周、48周观察肝功能。结果:随访12周、24周、48周,治疗组与对照组比较,在血清谷丙转氨酶、血清白蛋白、总胆红素、胆碱酯酶等肝功能指标方面有明显改善(P<0.01),血清球蛋白指标无明显改善(P>0.05)。结论:核苷类似物抗病毒治疗后肝功能失代偿期的乙肝肝硬化患者,进行自体干细胞原位移植治疗可以明显改善肝功能状况。

Objective：To observe the changes of liver function indexes of patients with decompensate type B hepatitis cirrhosis（DBHC） by using recombinant human colony-stimulating factor（CSF） to mobilize bone marrow stem cells,and to release them into blood circulation.Methods：One hundred and thirty-two DBHC patients who had accepted nucleoside analogue anti-hepatitis B virus treatment for consecutive 3 months but liver function index could improve no more were randomly divided into treatment group（group T） and control group（group C） with 66 in each group.Patients in group T were given CSF 300 μg once daily for consecutive 5 days.Liver functions were observed in 12,24 and 48 weeks.Results：Compared with group C,liver function indexes such as serum alanine aminotransferase,albumin,total bilirubin and cholinesterase of patients in group T ameliorated in 12,24 and 48 weeks after CSF treatment respectively（P0.01）,but globulin did not change significantly（P0.05）.Conclusions：Bone marrow stem cell orthotopic transplantation can ameliorate liver functions in patients with severe cirrhosis.