自体骨髓单个核细胞肝内移植治疗失代偿期肝硬化

背景：大量研究发现，骨髓间充质干细胞是肝干细胞的主要肝外来源，骨髓间充质干细胞在特定环境下可分化为肝组织和肝细胞从而参加肝脏的修复与重建。 目的：观察自体骨髓单个核细胞移植治疗失代偿期肝硬化的效果及安全性。 方法：选择肝硬化失代偿期患者20例，在无菌条件下由髂后上棘抽取骨髓200 mL，在体外分离纯化骨髓单个核细胞并制成10 mL细胞悬液，经肝动脉将细胞悬液移植入肝脏，分别在移植后第2、4、8、12周复查肝脏功能，观察实验室指标，临床症状及不良反应。 结果与结论：移植后2周内所有血清学指标均无显著改变，移植后4周白蛋白由(27.05±5.23) g/L升到(30.02±5.02) g/L，纤维蛋白原由(1.55±0.53) g/L升到(2.55±0.53) g/L，凝血酶原时间由(24.05±5.23) s降到 (17.05±5.13) s，胆碱酯酶和甲胎蛋白也有不同程度上升，氨基转移酶、总胆红素水平在移植前后无显著性变化。单个核细胞移植后食欲改善、体力好转10例，腹胀减轻6例，腹水减少7例，下肢浮肿减轻4例。全部患者在移植中未发生严重并发症，移植近期无不良反应出现。

Intrahepatic transplantation of autologous bone marrow mononuclear cells in treatment of liver cirrhosis in decompensatory period

BACKGROUND: Numerous studies have shown that bone marrow mesenchymal stem cells (BMSCs) are the main source of hepatic stem cells except for liver. BMSCs can differentiate into hepatic tissues and hepatic cells under a certain condition, and participate in the repair and reconstitution of the liver. OBJECTIVE: To observe the effect and safety of autologous bone marrow mononuclear cell transplantation in treatment of cirrhosis in decompensatory period. METHODS: A total of 20 patients with cirrhosis in decompensatory period were selected. 200 mL bone marrow was aspirated from posterior superior iliac spine in aseptic conditions. Bone marrow mononuclear cells were isolated and purified in vitro and made into 10 mL cell suspension. The stem cells were transplanted into the liver via hepatic artery. Liver function was rechecked at 2, 4, 8 and 12 weeks after transplantation. Laboratory data, clinical symptoms and adverse effects were observed. RESULTS AND CONCLUSION: No significant changes in serological indexes were detected within 2 weeks after transplantation. The levels of albumin were increased from (27.05±5.23) g/L to (30.02±5.02) g/L; fibrinogen was increased from (1.55±0.53) g/L to (2.55±0.53) g/L; prothrombin time was deceased from (24.05±5.23) s to (17.05±5.13) s; cholinesterase and alpha fetoprotein was increased at different levels; no significant changes in aminoleucine transferase and total bilirubin levels were detectable. Appetite was improved and physical capacity was recovered in 10 cases; abdominal distention was alleviated in 6 cases; ascites was decreased in 7 cases; lower extremity edema was decreased in 4 cases after transplantation. There were no serious intraoperative complications. Patinets had no adverse reaction.