自体骨髓干细胞移植治疗失代偿期肝硬化患者的疗效观察

Transplantation of autologous bone marrow stem cells via hepatic artery in 425 patients with decompensated cirrhosis

目的探讨自体骨髓干细胞经肝动脉移植治疗失代偿期肝硬化的安全性和疗效。方法选择失代偿期肝硬化患者425例,在常规治疗的前提下抽取骨髓100～150ml,在体外分离纯化单个核细胞并制成细胞悬液,经肝动脉将其移植入肝脏,术后2、4、8、12周观察患者临床症状、体征及实验室指标。结果患者术中和术后均未出现严重的并发症和不良反应。术后第2周,213例(59%)患者双下肢浮肿明显减轻,第8周时,297例(70%)患者精神、体力、食欲恢复正常,第12周时,ALB由26.6±5.2 g/L升至37.5±4.9g/L(P<0.05),ALT由150.7±19.5U/L降至30.7±7.7U/L(P<0.05),AST由85.6±32.5U/L降至20.5±15.7U/L(P<0.05),TBIL由154.4±20.2μmol/L降至52.3±17.4μmol/L(P<0.05),PT由20.1±1.7s降至15.4±1.5s(P<0.05),肝脏CT值由35.32±6.68Hu升至42.32±3.26Hu(P<0.05)。结论经肝动脉行自体骨髓干细胞移植治疗失代偿期肝硬化安全有效。

Objective To explore the effect and safety of autologous bone marrow stem cell transplantation via hepatic artery in treatment of patients with decompensated cirrhosis.Methods 425 patients with decompensated liver cirrhosis were selected for the trail.Beside the conventional treatment,the bone marrow stem cells were transplanted into the liver via hepatic artery.The biochemical index of liver function,abdominal B ultrasound and liver CT were detected at different times after transplantation.Results There was no severe side effects in all the 425 patients after the operation.2 weeks after transplantation,abdominal distention was alleviated in 213 patients,8 weeks after transplantation,appetite was improved in 297 patients.12 weeks after transplantation,ALB increased from 26.6±5.2g/L to 37.5±4.9g/L（P0.05）,ALT decreased from 150.7±19.5U/L to 30.7±7.7U/L（P0.05）,AST decreased from 85.6±32.5U/L to 20.5±15.7 U/L（P0.05）,TBIL decreased from 154.4±20.2μmol/L to 52.3±17.4μmol/L,PT decreased from 20.1±1.7s to 15.4±1.5s.Conclusion Transplantation of autologous bone marrow stem cells via hepatic artery is safe and effective in the treatment of patients with decompensated cirrhosis.