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自体外周血CD34+干细胞移植治疗晚期肝硬化100例的临床疗效分析 被引量:9

Autologous peripheral blood CD34+ stem cells transplanted into 100 patients with advanced cirrhosis
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摘要 目的 探索克服供体肝脏短缺的新途径,观察自体外周血CD34+干细胞移植治疗100例晚期肝硬化的临床疗效.方法 对内科严格保守治疗无效的100例晚期肝硬化患者,采用自体外周血CD34+干细胞移植,分别在术后6个月、12个月观察肝生物合成功能(凝血功能、白蛋白水平、吲哚青绿试验、Child Pugh评分)、肝脏的组织病理学改变(Knodell评分)、以及肝脏形态学改变.组间比较及组内比较均先进行方差齐性检验,当方差分析有意义时,采用Bonferroni检验行组内两两比较.结果 100例患者术后1年生存率100%,其中52例大量腹水患者术后腹水逐渐减少直到消失.4例术后3个月出现上消化道出血,3例出现Ⅰ~Ⅱ度肝性脑病.移植术后肝脏合成功能、肝脏储备功能、肝弹性测定及肝总组织检查(Knodell评分)均有显著改善,与移植前相比差异有统计学意义(P<0.05).结论 自体外周血CD34+干细胞移植是安全、有效和性价比高的方法;CD34+干细胞能有效地改善晚期肝硬化患者的肝脏功能、肝组织形态学以及提高患者的生活质量. Objective To investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors.Methods A total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up.Results The 1-year cumulative survival rate was 100%.Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (Ⅰ-Ⅱ degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P〈 0.05).Conclusion Autologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.
出处 《中华肝脏病杂志》 CAS CSCD 北大核心 2014年第9期667-670,共4页 Chinese Journal of Hepatology
基金 四川省卫生厅资助项目(100487)
关键词 肝功能试验 肝硬化 干细胞移植 治疗 Liver function tests Liver cirrhosis Stem cell transplantation Therapy
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