自体干细胞移植治疗胆汁性肝硬化的临床疗效及对患者肝脏弹力硬度、血清TGF-β1、SIL-2R水平的影响

Curative Efficacy of Autologous Stem Cell Transplantation in the Treatment of Biliary Cirrhosis and its Effects on the Serum TGF-β1 and SIL-2R Levels

目的:探讨自体干细胞移植治疗胆汁性肝硬化的临床疗效及对患者肝脏弹力硬度、血清转化生长因子-β1(TGF-β1)、可溶性白细胞2受体(SIL-2R)水平的影响。方法:选取2015年1月至2017年8月于我院就诊90例的胆汁性肝硬化患者作为本研究对象,采用随机数表法将其分为观察组和对照组,每组45例。对照组给予熊去氧胆酸胶囊、多烯磷酯酰胆碱胶囊、复方甘草酸苷片等常规治疗,连续治疗24周;观察组在和对照组相同方法治疗4周后,进行自体干细胞移植治疗。比较两组的临床疗效、治疗前和治疗后24周的肝功能、肝脏弹力硬度值、血清TGF-β1、SIL-2R水平的变化及不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率为86.67%(39/45),明显高于对照组[66.67%(30/45)](P<0.05)。两组治疗后血清碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)较治疗前均显著降低(P<0.05),且观察组血清ALP、GGT、ALT、AST、TBil水平均明显低于对照组(P<0.05)。两组治疗后肝脏弹力硬度值较治疗前均明显降低(P<0.05),且观察组肝脏弹力硬度值明显低于对照组[(6.20±1.05) kPa vs.(7.33±1.27) kPa](P<0.05)。两组治疗后血清TGF-β1、SIL-2R水平较治疗前均明显降低(P<0.05),且观察组血清TGF-β1、SIL-2R水平均明显低于对照组[(7.40±1.21)ng/mL vs.(9.23±1.49)ng/mL,(130.45±11.03)ng/L vs.(162.93±15.62)ng/L](P<0.05)。两组不良反应总发生率分别为11.11%(5/45)、15.56%(7/45),组间比较差异无统计学意义(P>0.05)。结论:自体干细胞移植治疗胆汁性肝硬化患者的临床效果显著,可有效改善患者肝功能、肝脏弹力硬度值,降低血清TGF-β1、SIL-2R的表达,且安全性高。

Objective: To study the curative efficacy of autologous Stem cell transplantation in the treatment of biliary cirrhosis and its effects on the serum transforming growth factor β1(TGF-β1) and soluble interleukin 2 receptor(SIL-2 R) levels. Methods: 90 cases of patients with primary biliary cirrhosis who were treated from January 2015 to August 2017 in our hospital were selected and di-vided into the observation group and the control group with 45 cases in each group according to random number table. The control group was given conventional treatment for 24 weeks, such as Ursodeoxycholic Acid Capules, polyene ester choline capsule, Compound Glycyrrhizin Tablets and so on. The observation group was treated with the same method as the control group for 4 weeks, autologous stem cell transplantation was performed. The clinical efficacy, the changes of liver function, liver elasticity hardness, serum TGF-β1 and SIL-2 R levels before and at 24 weeks after treatment, and the incidence of adverse reactions were compared between the two groups.Results: After treatment, the total effective rate of observation group was 86.67%(39/45), which was significantly higher than that of the control group[66.67%(30/45)](P<0.05);the alkaline phosphatase(ALP), glutamyl transaminase(GGT), alanine aminotransferase(ALT),aspartate aminotransferase(AST), and total bilirubin(TBil) levels of both groups were significantly lower than those before treatment(P<0.05), and the serum ALP, GGT, ALT, AST and TBil levels of observation group were significantly lower than those of the control group(P<0.05);the liver elastic hardness value of both groups were significantly lower than those before treatment(P<0.05), which was significantly lower in the observation group than that of the control group [(6.20±1.05) kPa vs.(7.33±1.27) kPa](P<0.05);the serum TGF-β1 and SIL-2 R levels of both groups were significantly lower than those before treatment(P<0.05), and the serum TGF-β1 and SIL-2 R levels of observation group were significantly lower than those of the control group [(7.40±1.21) ng/ml vs.(9.23±1.49) ng/ml,(130.45±11.03) ng/L vs.(162.93±15.62) ng/L](P<0.05);the total incidence of adverse reactions in two groups were 11.11%(5/45)and 15.56%(7/45) respectively, and there was no significant difference between two groups(P>0.05). Conclusion: Autologous Stem cell transplantation is effective for biliary cirrhosis, which can effectively improve the liver function, liver elastic hardness, and reduce the expression of TGF-β1 and SIL-2 R in serum with high safety.