经门静脉移植脐带血干细胞治疗失代偿期肝硬化患者30例疗效观察

Umbilical cord blood stem cell transplantation via the portal vein: analysis of the curative rate in 30 patients with decompensated liver cirrhosis

目的探讨经门静脉移植脐带血干细胞治疗失代偿期肝硬化患者的安全性及对肝功能的改善作用。方法选择失代偿期肝硬化患者61例,分为治疗组30例和对照组31例。对照组行护肝治疗,治疗组在此基础上行超声介入下经皮经肝穿刺至门静脉注入脐带血干细胞治疗。治疗后第2、4和8周检测血清ALT、AST、TBil、凝血酶原时间(PT)和白蛋白(Alb)水平变化。同时观察临床症状的改善情况及术后的不良反应。结果治疗后第3 d治疗组患者(100%)乏力、纳差症状改善,而对照组只有2例(6.4%)改善,两组间差异有统计学意义(P<0.05);治疗后8周,治疗组和对照组血清Alb水平分别为(36.4±7.8)g/L和(26.4±8.2)g/L,差异有统计学意义(P<0.05),两组凝血酶原活动度(PTA)分别为(57.2±11.8)%和(46.8±10.7)%,差异有统计学意义(P<0.05);血清ALT、AST、TBil在两组间变化不明显。随访两组甲胎蛋白(AFP)水平未见明显差异,未发现严重的不良反应及并发症。结论经门静脉移植脐带血干细胞治疗失代偿期肝硬化患者有一定的疗效及安全性。

Objective The aim of this study was to observe the curative effect and safety of umbilical cord blood stem cells（UCBSCs） following transplantation via the portal vein into 30 patients with decompensated liver cirrhosis.Methods Sixty-one patients with decompensated liver cirrhosis were assigned to either the control group（treated with conventional therapy） or the UCBSCs therapy group（with transplantation via the portal vein plus conventional therapy）.Intergroup differences in outcome,serum biochemical index,and adverse events were analyzed.Results All patients in the UCBSCs therapy group achieved an obvious improvement in their clinical symptoms following treatment,while only 4.0% of patients in the control group improved.At eight weeks post-therapy,the level of serum albumin was significantly higher in the UCBSCs therapy group than in the control group [（36.4±7.8）g/L vs.（26.4±8.2）g/L,P0.05].The prothrombin activity was also significantly higher in the UCBSCs therapy group than in the control group [（57.2±11.8）% vs.（46.8±10.7）%,P0.05].The levels of serum alanine aminotransferase,aspartate aminotransferase,total bilirubin,and alpha fetoprotein were not significantly different between the two groups.No serious adverse reactions or complications occurred in either group.Conclusion Transplantation of umbilical cord blood stem cells via the portal vein is effective and safe for treating patients with decompensated liver cirrhosis.