自体骨髓干细胞移植治疗失代偿期肝硬化的疗效观察

Autologous bone marrow stem cell transplantation for treatment of decompensate liver cirrhosis

目的观察自体骨髓干细胞移植治疗失代偿期肝硬化的疗效。方法选取失代偿期乙肝后肝硬化患者25例,随机分为治疗组和对照组,其中治疗组患者12例,对照组13例。两组患者均采用抗病毒、护肝、利尿等内科基础治疗,治疗组患者除上述治疗措施外,采用自体骨髓干细胞经肝动脉移植治疗2次,2次治疗间隔1个月。观察患者症状及体征如腹胀、纳差、乏力、腹水的好转情况,及各项实验室指标变化,影像学改变,同时观察不良反应。结果移植后24周,患者腹胀、纳差、乏力、腹水有效率分别为100%(12/12);91.7%(11/12);91.7%(11/12);83.3%(10/12),对照组分别为7.7%(1/13);15.4%(2/13);7.7%(1/13);7.7%(1/13),差异有显著性。术后24周时各实验室指标如总胆红素(T-bil)(47.3±15.8)umol/L降至(33.1±13.2)umol/L;谷丙转氨酶(ALT)(77.2±23.5)U/L降至(53.2±16.8)U/L;谷草转氨酶(AST)(57.3±14.4)U/L降至(42.1±13.6)U/L;白蛋白水平(ALB)(28.2±5.8)g/L升至(33.8±5.4)g/L;纤维蛋白原(FIB)(1.76±0.33)g/L升至(2.27±0.29)g/L;凝血酶原时间(PT)(17.2±2.3)s降至(13.2±2.0)s,差异有显著性。术后24周复查CT,肝脏最大截面积由(138.6±21.3)cm2增至(165.2±28.7)cm2,差异有显著性。对照组各项指标与入院时比较差异无显著性。且移植不良反应轻微。结论自体骨髓干细胞移植治疗失代偿期肝硬化疗效显著,副作用小,值得推广。

【Objective】To observe the effect of autologous bone marrow stem cell transplantation in the treatment of decompensated cirrhosis.【Methods】Twenty-five decompensated cirrhosis patients after hepatitis B were divided into treatment group including twelve patients and control group including thirteen patients randomly. All the patients were treated with basic medical treatment such as antiviral therapy, liver protection, diuresis, etc. Patients in treatment group were given autologous bone marrow stem cell transplantation through hepatic artery twice additionally. The interval of the two treatments was one month. Symptoms and signs including abdominal distention, and anorexia, fatigue, and ascites, laboratory data and imaging examination were observed. The adverse reactions were recorded. 【Results】Twenty-four weeks after transplantation, the efficiency of abdominal distention, anorexia, fatigue, ascites was 100%（12/12）; 91.7%（11/12）; 91.7%（11/12）; 83.3%（10/12） respectively. It was 7.7%（1/13）; 15.4%（2/13）; 7.7%（1/13）; 7.7%（1/13） in the control group at the same time. The difference was statistically significant. Twenty-four weeks after transplantation, laboratory data total bilirubin level was decreased from（47.3± 15.8） umol/L to（33.1±13.2） umol/L; alanine aminotransferase was decreased from（77.2±23.5） U/L to（53.2±16.8） U/ L; aspartate aminotransferase was decreased from（57.3±14.4） U/L to（42.1±13.6） U/L; level of albumin was increased from（28.2±5.8） g/L to（33.8±5.4） g/L; fibrinogen was increased from（1.76±0.33） g/L to（2.27±0.29） g/L; prothrombin time was decreased from（17.2±2.3） s to（13.2±2.0） s. The difference was statistically significant. Twenty-four weeks after transplantation, the data of the largest cross-sectional area of liver CT scanning was increased from（138.6±21.3） cm^2 to（165.2±28.7）cm^2. The difference was statistically significant. The difference of laboratory data in patients of control group was not statistically significant after treatment. The adverse reactions of transplantation are slight. 【Conclusions】Autologous bone marrow stem cell transplantation is effective in the treatment of decompensate liver cirrhosis and its adverse reactions are slight. It is worth promoting.