拉米夫定和阿德福韦酯初始联合及脐血干细胞治疗失代偿期肝硬化临床研究

Umbilical cord blood stem cell combined with adefovir dipivoxil and lamivudine,the de novo combination therapy on decompensated liver cirrhosis

目的探讨脐带血干细胞输注及拉米夫定(LAM)、阿德福韦酯(ADV)初始联合治疗失代偿期乙型肝炎肝硬化的临床效果。方法选择失代偿期乙型肝炎肝硬化患者56例,给予ADV 10mg/d和LAM 100mg/d口服,脐带血干细胞细胞悬液[含单个核细胞(15～35)×109/L]100ml静脉输注,每周1次,连续3次。治疗后将患者血常规、肝功能(ALT、AST、ALB、TBil、DBil)、病毒血清学指标进行比较。结果 56例患者的肝功能(如ALT、AST、TB、ALB)等血清学指标,治疗前后差异有统计学意义(P<0.05),血常规(如WBC、PLT等)、HBVDNA载量比较差异有统计学意义(P<0.05)。结论脐带血干细胞输注及LAM、ADV初始联合治疗失代偿期乙型肝炎肝硬化可迅速显著地抑制HBVDNA的复制,降低病毒载量,有效减轻肝脏的炎性反应,减少肝细胞坏死损伤,促进肝细胞再生,加速肝功能恢复。

Objective To investigate the effects of umbilical cord blood stem cell transplantation and treatment of adefovir dipivoxil combined with lamivudine in patients with decompensated hepatitis B cirrhosis. Methods Total of 56 cases with decompensated hepatitis B cirrhosis received adefovir dipivoxil tablets 10 mg/d and lamivudine tablets 100 mg/d. The 100 ml of suspension liquid of umbilical cord blood stem cell [with single cells （15-35） × 10^9/L] by intravenous infusion for once a week with continuous 3 times. After treatment, liver function tests （ALT, AST, ALB, TBil and DBil） and viral serology were compared. Results Serum markers of liver function before and after treatment of 56 cases were significantly different （P 〈 0.05）, HBV DNA load were significantly different （P 〈 0.05）. Conclusions The umbilical cord blood stem cell transplantation and treatment of adefovir dipivoxil combined with lamivudine in decompensated hepatitis B cirrhosis can significantly inhibit the rapid HBV DNA replication, reducing viral load, effectively reducing liver inflammation and liver necrosis injury, also promoting regeneration of liver cells, and accelerating the recovery of liver function.