自体骨髓干细胞移植对失代偿期肝硬化患者肝纤维化指标的近期影响

Changes in biochemical markers of liver fibrosis in patients with decompensated liver cirrhosis after autologous bone marrow stem cell infusion

目的:探讨经肝动脉插管自体骨髓干细胞移植对失代偿期肝硬化患者肝纤维化指标的近期影响.方法:收治失代偿期肝硬化患者50例.从患者髂后上棘抽取骨髓,体外分离纯化骨髓源性干细胞,通过肝动脉插管注入肝脏,在移植后4、8 wk复查肝功能和肝纤维化指标(Ⅲ型前胶原、Ⅳ型胶原、层黏连蛋白、透明质酸酶),观察实验室指标改善、腹水变化及不良反应情况.结果:移植前后白蛋白升高有统计学意义(P<0.05).丙氨酸氨基转移酶值较术前有下降,凝血酶原活动度有不同程度升高,但两项指标差异无统计学意义(P>0.05).术后腹水减轻或消失,与术前比较有统计学意义(P<0.05).Ⅲ型前胶原、Ⅳ型胶原、透明质酸酶和层黏连蛋白较术前均有下降,其中Ⅲ型前胶原和透明质酸酶下降明显(P<0.05).结论:自体骨髓干细胞移植可减轻失代偿期肝硬化患者的肝纤维化程度,但需要进一步证实.

AIM：To evaluate the effect of autologous bone marrow stem cell infusion on biochemical markers of liver fibrosis in patients with decompensated liver cirrhosis.METHODS：Fifty patients with decompensated liver cirrhosis were included in the study.The bone marrow harvested from the ilium of patients was isolated and purified,and the final bone marrow stem cells were administered via the hepatic artery.The levels of biochemical markers of liver fibrosis were examined before transplantation,4 and 8 wk after transplantation.Clinical manifestations and complications of transplantation were recorded during the follow-up period.RESULTS：The level of serum albumin and the extent of ascites were improved significantly at 4 and 8 wk after transplantation than before transplantation（P〈0.05）.The levels of serum alanine aminotransferase,total bilirubin,and prothrombin activity were improved after transplantation,however,the changes were not statistically significant（P〉0.05）.Biochemical markers of liver fibrosis such as procollagen type Ⅲ,type Ⅳ collagen,laminin,and hyaluronic acid enzyme were decreased after treatment,of which procollagen type Ⅲand hyaluronic acid enzyme were improved significantly（P〈0.05）.CONCLUSION：Biochemical markers of liver fibrosis a re improved in patients with decompensated liver cirrhosis after autologous bone marrow stem cell infusion.