介入治疗联合干细胞移植治疗肝硬化临床分析

The Efficacy of Interventional Therapy Togetherwith Stem Cell Transplantation in Treatment of Decompensated Cirrhosis

目的:探讨和评价介入治疗联合干细胞移植治疗失代偿期肝硬化的近期疗效及其安全性。方法:30例失代偿期肝硬化患者,随机分为3组,每组各10例。A组仅行药物治疗,B组行TIPS治疗,C组行TIPS联合脐带血干细胞移植治疗。术前1周、术后1月及术后3月观察3组患者丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)水平变化及并发症情况。结果:手术及干细胞移植顺利,3组患者术前ALT、ALB、TB均无明显差异;A组患者药物治疗前后肝功能无特殊变化;B组患者术后1月、3月时ALT(P<0.01)及术后1月时TB(P<0.05)较术前升高;C组患者术后3月时ALT较术前减低,ALB则较术前明显升高(P<0.01),但ALB(30.78±0.69 g/L)仍低于正常下限(35 g/L)。术后1月时B组ALT及TB均较A组及C组升高(P<0.05);术后3月时C组患者ALT较其他组降低明显(P<0.05),而ALB则较其他组升高(P<0.01)。C组术后并发肝性脑病1例,术后3月肝胆CT检查分流道通畅,未见占位病变。结论:介入治疗联合干细胞移植治疗失代偿期肝硬化安全可靠,近期疗效显著。

Objective：To evaluate and assess the short - term efficacy of interventional therapy togetherwith stem cell transplantation in the treatment of patients with decompensated cirrhosis. Methods：30 patients were divided into three groups randomly. Group A only used drugs, group B adopted TIPS , group C adopted TIPS and umbilic cord blood stem cell transplantation. Alanine aminotransferase （ALT）, albumin（ALB） and total bilirubin （TIBL） were observed at pre - operation, 1 month and 3 months after transplantation were measured and analyzed in each group. The adverse reaction was also observed. Results：TIPS and translation was carried out successfully. There had no significant different of ALT ALB and TB between 3 groups pre - operation. It showed no significant change in group A. Yet in group B the level of ALT was increased at 1 and 3 months after TIPS（P 〈0. O1 ） ,and so did TB at 1 month after operation （P 〈0. 05）. ALT decreased significantly at 3 months after transplantation（ P 〈 0. 05 ） in group C, and the level of ALB increased significant- ly at the same time although it still under the lower limit （35 g/L）. The level of ALT and TB was higher in group B at 1 month after TIPS compared with A and C （ P 〈 0.05 ）. While in group C, ALT was lower at 3 months after transplantation（P 〈 0. 05 ）, but ALB was much higher compared with A and C （ P 〈 0. 01 ）. Hepatic encephalopathy occurred in 1 patient of C group. No occupying lesions was detected in liver by CT at 3 month post - transplantation and no stents were obstructed in B and C groups. Conclusions：Interven- tional therapy togetherwith stem cell transplantation in the treatment of patients with decompensated cirrhosis was a safe and recommendable method with creditable short - term efficacy.