脐血间充质干细胞移植治疗失代偿期肝硬化的临床疗效观察

Human Umbilical Cord Blood MSCs Transplantation in Treatment of Decompensated Liver Cirrhosis

目的探讨脐血间充质干细胞移植治疗失代偿期肝硬化的临床疗效。方法选择2009年8月—2011年2月在郑州大学附属郑州市中心医院就诊的失代偿期肝硬化患者46例,采用随机数字表法分为治疗组24例,对照组22例。对照组患者给予常规治疗,治疗组在常规治疗基础上加用脐血间充质干细胞移植治疗。观察两组患者治疗前,治疗1、2、4、8、12周时血浆清蛋白、前清蛋白、总胆红素水平变化及不良反应发生情况,并于治疗前、治疗12周时对治疗组患者进行SF-36量表(中文版)评分。结果两组患者治疗前,治疗1、2周时血浆清蛋白、前清蛋白水平比较,差异均无统计学意义(P>0.05);治疗组治疗4、8、12周时血浆清蛋白、前清蛋白水平高于对照组(P<0.05);两组患者治疗前,治疗2、4、8、12周时总胆红素水平比较,差异均无统计学意义(P>0.05);治疗组治疗1周时总胆红素水平高于对照组(P<0.05)。治疗组患者治疗后躯体功能、肢体疼痛、总的健康状况、活力、社会功能、心理健康领域评分均高于治疗前(P<0.05),且均有临床和统计学意义;而躯体角色、情绪角色评分治疗前后比较,差异均无统计学意义(P>0.05),亦无临床和社会意义。两组患者均未出现皮疹、恶心、出血、感染等不良反应。结论脐血间充质干细胞移植治疗失代偿期肝硬化安全有效,能有效改善患者肝功能和生活质量,延缓其病程进展。

Objective To investigate the clinical effects of human umbilical cord blood （UCB） mesenchymal stem cell （MSCs） transplantation in treatment of decompensated liver cirrhosis （ DLC ）. Methods Twenty - six DLC patients admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University hospital from August 2009 to February 2011 were divided randomly into groups study （ n = 24） , control （ n = 22）. The control group were given conventional therapy, study group given additional UCB MSCs transplantation. The plasma albumin （ALB） , prealbumin （PAB） , total bilirubin （TBiL） and adverse reactions were observed before treatment and after 1, 2, 4, 8, 12 weeks of treatment, and the study group scored by SF- 36 Scale （ Chinese version） before treatment and after 12 weeks of treatment. Results There was no significant difference in ALB, PAB levels between 2 groups before treatment and after 1, 2 weeks of treatment （ P 〉 0. 05 ）, and higher in study group than in control group after 4, 8, 12 weeks of treatment （ P 〈 0.05 ）. There was no significant difference in TBiL level between 2 groups before treatment and after 2, 4, 8 12 weeks of treatment （P 〉0. 05）, higher in study group than in control group after 1 week of treatment （P 〈 0. 05）. The scores of physical function, limb pain, general health, vitality, social function, mental health in study group were higher after treatment than before （ P 〈 0. 05 ） , but there was no significant difference in physical role, emotional role between pre - and post - treatment （ P 〉 0. 05 ）. Both groups had not rash, nausea, bleeding, infection and other adverse reactions. Conclusion UCB MSCs transplantation, safe and effective in treatment of DLC, can effectively improve patients＇ liver function and quality of life and delay its progression.