重复测量分析脐带间充质干细胞移植治疗肝硬化的疗效

Umbilical cord mesenchymal stem cell transplantation for liver cirrhosis:a repeated measurement analysis

背景:国内外已有应用间充质干细胞治疗肝硬化的临床研究且取得了可喜的进步,但在实际应用中,经常会误用t检验分析这类资料。目的:采用重复测量方法分析脐带间充质干细胞治疗肝硬化患者的有效性和安全性。方法:失代偿性肝硬化患者27例,均行常规内科治疗,包括护肝、对症治疗等。在入院1周后静脉移植脐带间充质干细胞(第2-4代),细胞存活率≥90%,干细胞数量≥2×107个,共治疗4次,每次间隔5-7 d。使用重复测量方差分析脐带间充质干细胞移植治疗不同时点的肝功能变化。结果与结论:单变量重复测量方差分析结果显示,在治疗后2,3个月时血清白蛋白升高、总胆红素降低,与治疗前比较差异有显著性意义(P<0.05);治疗后3个月,谷草转氨酶降低、胆碱酯酶升高,与治疗前比较差异有显著性意义(P<0.05),所有患者在观察期内无肝脏及其他器官肿瘤发生。结果表明脐带间充质干细胞移植治疗肝硬化安全有效,患者肝功能得到改善。

BACKGROUND： The research for mesenchymal stem cells in the treatment of liver cirrhosis has made great progress. However, t-test analysis is often misused in clinical pr.actice. OBJECTIVE： To analyze the efficacy and safety of umbilical cord mesenchymal stem cell therapy for liver cirrhosis by repeated measurement method. METHODS： A total of 27 patients with decompensated liver cirrhosis underwent conventional medical treatments, including liver protection treatment and symptomatic treatment. At 1 week after hospitalization, patients were given intravenous transplantation of umbilical cord mesenchymal stem cells （passages 2-4）, cell viability ≥ 90% stem cell counting ≥ 2× 107 cells, four times with an interval of 5-7 days. Analysis of variance based on repeated measurement data was performed to analyze the liver function changes at different time after umbilical cord mesenchymal stem ceil transplantation. RESULTS AND CONCLUSION： The results of univariate repeated measurement showed that at 2 and 3 months after treatment, the serum albumin level was increased and the total bilirubin level in serum was decreased significantly （P 〈 0.05）; at 3 months after treatment, the content of aspartate aminotransferase decreased, and the content of cholinesterase increased significantly （P 〈 0.05）. No patient appeared to have liver and other organ tumors during the observation period. These findings indicate that umbilical cord mesenchymal stem cell transplantation is effective and safe in the treatment of liver cirrhosis, which can significantly improve patient＇s liver functions.