自体骨髓干细胞肝内移植治疗失代偿期肝硬化的初步临床观察

目的探讨自体骨髓干细胞肝内移植治疗失代偿期肝硬化的临床效果。方法36例肝硬化失代偿期患者,采取经肝动脉(31例)或门静脉(5例)途径肝内移植自体骨髓干细胞,移植术后3个月观察血清转氨酶(ALT)、总胆红素(TB)、凝血酶原时间(PT)和白蛋白(ALB)水平变化,同时观察临床症状的改善情况。结果移植术后2周,ALT、TB、PT和ALB开始好转,术后2个月、3个月,ALT、TB和PT均较术前明显改善(P<0.05),而ALB直到术后3个月才明显好转(P<0.05)。5例患者移植术后腹水加重,1例因腹腔感染并肝功能衰竭死亡,1例因上消化道大出血死亡。移植后2个月,腹水减轻的占70.8%(17/24),乏力好转的占83.9%(26/31),食欲改善的占90.3%(28/31)。移植术中和术后,未见明显不良反应和并发症发生。结论自体骨髓干细胞肝内移植治疗失代偿期肝硬化是一种安全的治疗措施,可起到暂时性的肝脏支持作用。

Intrahepatic transplantation of bone marrow stem cells via hepatic artery or portal vein in the patients with liver cirrhosis

Objective To investigate the efficacy of intrahepatic transplantation of bone marrow stem cells in the treatment of liver cirrhosis. Methods Thirty-six consecutive patients with cirrhosis received transplantation of bone marrow stem cells via hepatic artery (31 cases) or portal vein (5 cases). The level of serum alanine aminotransferase (ALT), total bilirubin (TB), prothrombin time (PT) and albumin (ALB) were examined before transplantation, 3 days to 3 months after transplantation, simultaneously the improvement of clinical syndrome also were observed after transplantation. Results From the second week after transplantation, the level of ALT, TB, PT and ALB began to improve, and their level were improved significantly at the second month and the third month after transplantation in comparison with those of before transplantation (P<0.05). After transplantation, 5 patients developed a large amount of ascites because of low ALB level, 2 patients died of liver functional failure and variceal bleeding. Two months after transplantation, ascites was reduced in 17 patients (70.8%), debility and appetite were improved in 26 patients (83.9%) and 28 patients (90.3%). No patient developed severe complications associated with transplantation. Conclusion Intrahepatic transplantation of bone marrow stem cells via hepatic artery or portal vein is a safe therapy, it can play a temporary support role for the patients with cirrhosis.