两种类型的干细胞经门静脉注入治疗失代偿期肝硬化患者近期疗效观察

Clinical effect of autologous bone marrow stem cells and umbilical cord blood stem cells injecting through portal vein in patients with decompensated liver cirrhosis

目的比较自体骨髓干细胞和脐带血干细胞经门静脉注入治疗失代偿期肝硬化患者的安全性及对肝功能和PTA的近期改善作用。方法选择失代偿期肝硬化患者59例,随机分为骨髓组31例和脐血组28例。骨髓组患者经门静脉注入自体骨髓干细胞治疗,脐血组经同样途径注入脐带血干细胞治疗。治疗8周后检测两组患者血清ALT、AST、TBil、PTA、ALB和AFP水平变化。同时观察对比患者临床症状的改善情况及术后的不良反应。结果细胞治疗3天,两组患者乏力、纳差症状均有改善,差异均无统计学意义(P均>0.05)。治疗8周,骨髓组和脐血组ALB水平分别上升至(34.8±6.3)g/L和(36.8±8.1)g/L,差异无统计学意义(P>0.05);PTA水平上升至(54.3±13.8)%和(57.0±15.2)%,差异无统计学意义(P>0.05);骨髓组血清ALT、AST、TBil和AFP分别为(43.2±13.8)U/L、(50.8±14.2)U/L、(34.5±14.7)μmol/L、(10.0±3.1)μg/L,脐血组分别为(46.3±12.3)U/L、(49.1±15.0)U/L、(31.4±12.5)μmol/L、(8.8±3.2)μg/L,两组差异均无统计学意义(P均>0.05)。结论经门静脉注入自体骨髓干细胞和脐带血干细胞治疗失代偿期肝硬化患者有一定的安全性及疗效,脐带血干细胞疗效优于自体骨髓干细胞,但两组疗效差异无统计学意义。

Objective To compare the safety and near-term curative effect in liver function and prothrombin activity of autologous bone marrow stem cells and umbilical cord blood stem cells injecting through portal vein in patients with decompensated liver cirrhosis. Methods Total of 59 patients with decompensated liver cirrhosis were randomly divided into bone marrow group （injecting autologous bone marrow stem cells） and umbilical cord blood group （injeccting umbilical cord blood stem cells）. The differences of symptoms, serum biochemical index and adverse events after 8 weeks in two groups were recorded and analyzed. Results All patients in two groups achieved an obviously improvement in their clinical symptoms such as fatigue and inappetence after 3 days. The difference has no significance. At eight weeks post therapy, the level of ALB was increased to （34.8 ± 6.3） g/L and （36.8 ± 8.1） g/L in bone marrow group and umbilical cord blood group, respectively. The level of PTA was increased to （54.3 ± 13.8）% and （57.0 ± 15.2）%, respectively. The above differences were not significant. The level of ALT, AST, TBil and AFP were （43.2 ± 13.8） U/L, （50.8 ± 14.2） U/L, （34.5 ± 14.7） μmol/L, （10.0 ± 3.1） μg/L in bone marrow group, respectively, and （46.3 ± 12.3） U/L, （49.1 ± 15.0） U/L, （31.4 ± 12.5） μmol/L, （8.8 ± 3.2） μg/L in umbilical cord blood group, respectively. There were not significantly different between two groups. Conclusions Injecting antologous bone marrow stem cells and umbilical cord blood stem cells through portal vein are safe and effective in treatment of patients with decompensated liver cirrhosis. The latter is better than the former, but has no difference between two groups.