自体外周血干细胞移植对乙型肝炎肝硬化失代偿期吲哚氰绿滞留率的影响分析

Effect of autologous peripheral blood stem cell transplantation on retention rate of indocyanine green in hepatitis B cirrhosis in decompensation period

目的观察自体外周血干细胞移植治疗对乙型肝炎肝硬化失代偿期患者吲哚氰绿滞留率的影响。方法采用前瞻性、随机对照分组法,将60例乙型肝炎肝硬化失代偿期患者分成两组,每组30例,一组为移植组,在接受综合内科治疗的基础上接受自体外周血干细胞移植治疗,一组对照组,仅接受综合内科治疗。观察自体外周血干细胞移植后12周、24周、36周、48周症状和体征变化、血总胆红素(TBil)、凝血酶原活动度(PTA)、白蛋白(Alb)水平、吲哚氰绿15 min滞留率(ICG R15)的变化以及移植后的副反应、肿瘤发生率等,并与移植治疗前及同期对照组比较。结果外周血干细胞移植治疗后,大多数患者腹水等症状改善,未出现严重不良反应;移植后24周、36周、48周Alb水平、PTA与移植前及对照组比较,差异均有统计学意义(P<0.01),移植后36周、48周ICG R15与移植前及12周比较,差异均有统计学意义(P<0.05)。结论自体外周血干细胞移植治疗乙型肝炎肝硬化失代偿期患者安全、有效。

Objective To observe the effect of autologous peripheral blood stem cell transplantation on the retention rate of indocyanine green in hepatitis B patients with cirrhosis in their decompensation period. Methods Sixty hepatitis B patients with cirrhosis in their decompensation period were divided into two groups according to the method of prospective, randomized, controlled grouping, with 30 cases in each group. One group was transplantation group and received autologous peripheral blood stem cell transplantation on the basis of comprehensive medical treatment. The other was control group and only received comprehensive medical treatment. Changes of symptoms and signs, serum total bilirubin （TBil）, prothrombin activity （PTA）, albumin（Alb） level, the changes of 15 min indocyanine green retention rate （ICG R15）, side effects after transplantation and tumor incidence were observed and compared with the control group and before transplantation at 12 weeks, 24 weeks, 36 weeks and 48 weeks after autologous peripheral blood stem cell transplantation. Results After peripheral blood stem cell transplantation, ascites and other symptoms of most patients were improved and no serious adverse reactions existed. The levels of Alb and PTA at 24 weeks, 36 weeks and 48 weeks after transplantation were statistically significant compared with those before transplantation and the control group（P〈 0.01）; and ICG R15 at 36 weeks and 48 weeks after transplantation was statistically significant compared with that be fore transplantation and 12 weeks（P〈0.05）. Conclusion Autologous peripheral blood stem cell transplantation in the treatment of hepatitis B patients with cirrhosis in their decompensation period is safe and effective.