自体骨髓干细胞肝内移植对失代偿期肝硬化患者肝脏生化及纤维化指标的影响

The influence of autologous bone marrow stem cells transplation on the indicators of biochemical and fibrosis liver of the patients with decompensated cirrhosis

目的观察自体骨髓干细胞肝内移植对失代偿期肝硬化肝脏生化及纤维化指标的影响,为临床治疗提供新方法。方法选择我院失代偿期肝硬化住院患者80例,随机分为2组:对照组40例,给予常规对症支持治疗、护肝治疗及必要的抗病毒治疗。治疗组40例,在对照组常规治疗方法基础上,采取经肝动脉途径自体骨髓干细胞肝内移植。观察术后临床症状改善及不良反应情况,并于术后2、4、8、12周进行肝功能、凝血功能检测,术后12周进行肝纤维化指标检测。将术后12周时检测结果进行比较。结果治疗组术后第1周全部患者(100%)乏力、纳差症状改善,35例(87.5%)腹胀减轻,而对照组只有2例(5.0%)乏力、纳差症状改善,6例(15%)腹胀减轻,两组间差异有统计学意义(P<0.05);治疗后12周,治疗组和对照组血清ALB水平分别为(38.5±8.2)g/L和(25.4±7.5)g/L,ALT和AST水平分别为(36.3±13.5)U/L,(33.6±14.5)U/L和(70.2±13.3)U/L,(68.6±13.8)U/L,TBIL水平分别为(28.3±12.4)μmol/L和(42.3±16.3)μmol/L,PTA分别为(63.0±11.4)%和(37.2±12.5)%,治疗组肝纤维化指标明显改善。两组治疗后肝脏生化及纤维化指标比较,差异有统计学意义(P<0.01)。治疗组2例在治疗后第2天出现低热,未发现其他不良反应及并发症。结论自体骨髓干细胞肝内移植治疗失代偿期肝硬化安全有效,在肝功能、凝血功能及肝纤维化指标改善方面均有显著作用。

Objective To provide new methods for clinical treatment through observing the influence of autologous bone marrow stem cells transplation on the indicators of biochemical and fibrosis liver of the patients with deeompensated cirrhosis. Methods 80 patients with decompensated cirrhosis in Xinxiang Infectious Dis- ease Hospital were randomly divided in two groups： 40 patients in control group were given regular symptomatic support treatment, liver protection treatment and the necessary antiviral treatment. On the basis of regular treat- ment of control group, 40 patients in treatment group were taken the hepatic artery way autologous stem cell within the liver transplantation. Observe the postoperative clinical symptoms improvement and adverse reaction conditions of the patients; detect liver function and coagulation function in 2nd, 4th, 8th, 12th weeks after the operation; to detect hepatic fibrosis indicators in the 12ta week after the operation. At last, the test results in the 12＇h week were compared. Results In the 1rd week after the operation, all patients（ 100% ） in treatment group had improved their weakness and NaCha Symptoms, 35 cases（87.5% ） had reduced their abdominal disten- sions. While only 2 cases （5.0%） had improved their weakness and NaCha Symptoms, 6 cases （ 15% ） had reduced their abdominal distensions. The difference between two groups had a statistical significance（P 〈 0. 05 ） 12 weeks after the treatment, serum ALB leverl of treatment group and control group are （38.5 ＋ 8.2）g/L and （25.4 ±7. 5） g/L. ALT level and AST level are （36. 3 ± 13.5）U/L and（33.6 ± 14. 5） U/L and （70. 2 ± 13.3） U/L, （68.6 ± 13.8） U/L. TBLL level are （28.3 ± 12.4） ±mol/L and （42. 3 ± 16. 3 ） Izmol/L; PTA are （63.0 ± 11.4） % and （ 37.2 ± 12. 5 ） %. Patients in treatment group had clearly improved their hepatic fi- brosis indicators. The difference between the two group in camparasion of the indicators of liver biochemistry andfibrosis has a statistical significance（P 〈 0. 01 ）. 2 patients in treatment group suffered low fever in the 2ad day after the treatment, no other adverse reactions and complications were found. Conclusion It is safe and effective to use autologous bone marrow stem cells transplation to treat the patients with decompensated cirrho- sis. There are significant role in the improvement of liver function, coagulation function and the indicators of liv- er fibrosis.