经外周静脉移植人脐血干细胞治疗失代偿期肝硬化临床疗效的研究

Study of curative effect of human umbilical cord blood stem cell transplantation via peripheral vein in the treatment of patients with decompensated cirrhosis

目的探讨人脐血干细胞(umbilical cord blood stem cell,UCBSC)经外周静脉移植治疗失代偿期肝硬化的临床疗效及安全性。方法对53例肝硬化失代偿期患者采用经外周静脉UCBSC移植治疗,移植术后2、4、8、12周观察血清转氨酶(ALT)、白蛋白(ALB)、纤维蛋白原(FIB)、凝血酶原时间(PT)、总胆红素(TB)水平变化,同时观察临床症状和体征的改善情况及不良反应。结果术后4、8、12周ALT、ALB、FIB和TB指标均有明显改善,差异有统计学意义(P<0.05),PT在术后8、12周指标有明显改善(P<0.05)。移植后12周食欲、体力改善率分别为75.5%(40/53)、67.9%(36/53)、腹水减少54.7%(29/53)。移植术中和术后未见明显不良反应。结论 UCBSC经外周静脉移植是治疗失代偿期肝硬化是一种有效、安全的方法,可以显著改善失代偿期肝硬化患者的肝功能、临床症状和体征。

Objective To investigate the effect and safety of human umbilical cord blood stem ceII（UCBSC） transplantation via peripheral vein in the treatment of patients with decompensated cirrhosis. Methods A total of 53 patients with decom- pensated cirrhosis received transplantation of UCBSC via peripheral vein. The alanine transaminase （ALT）, albumin （ALB）, fibrinogen （FIB）, prothrombin time （FT） and total bilirubin （TB） were examined before transplantation and 2,4,8,12 weeks after transplantation. Simultaneously the improvement in clinical symptoms and signs were observed and side effect of the treatment were recorded after the treatment. Results Significant improvement in ALT, ALB, FIB and TB was found after 4,8,12 weeks （P 〈 0.05）, the improvement in PT was found in 8 and 12 weeks after transplantation （P 〈 0.05）. Appetite was improved in 40 patients （75.5%）, debility was improved in 36 patients （67.9%） and aseite was relieved in 29 patients （54.7%） twelve weeks after transplantation. There is no patient suffered severe complications and adverse reactions associ- ated with transplantation. Conclusion UCBSC transplantation via peripheral vein in patients with deeompensated cirrhosis is an effective and safe way of treatment. It can improve significantly the indexes of liver function and clinical symptoms and signs in the patients.