自体骨髓干细胞移植治疗失代偿期肝硬化

目的 分析自体骨髓干细胞移植对肝硬化患者的治疗作用.方法 选择失代偿期肝硬化患者78例,其中肝炎肝硬化56例、酒精性肝病21例、血吸虫性肝硬化1例,年龄26～67岁.从患者髂后上棘抽取骨髓,体外分离纯化骨髓源性干细胞,通过肝动脉置管移植入肝脏,在移植后2、4、8周复查肝脏功能,观察实验室指标改善、Child-Turcotte-Pugh分数变化及不良反应情况.结果 移植后第4周,患者血浆白蛋白由(32.91±5.58)g/L升至(38.324±6.45)g/L,丙氨酸转氨酶由术前(96.92±83.91)U/L降至(73.48±18.46)U/L(P<0.01).凝血酶原时间从移植前的(16.66±3.91)s逐渐下降至移植后的(15.52±3.35)s,纤维蛋白原从(2.22±0.88)g/L逐渐升高至(2.58±0.88)g/L.干细胞移植术后患者临床症状明显改善,其中食欲改善、体力好转72例(92.3%),腹水减少或消失及下肢浮肿减轻70例(89.7%),腹胀减轻68例(87.2%).近期未发生与干细胞移植相关的并发症.结论 骨髓干细胞移植是治疗失代偿期肝硬化患者安全、有效的方法.

Transplantation of autologous bone marrow stem cells in treatment of patients with decompensated cirrhosis

Objective To analyze the effect of autologous bone marrow stem cells transplantation in treatment of patients with decompensated cirrhosis. Methodls Seventy-eight patients (aged from 26 to 67) with decompensated cirrhosis, including 56 with hepatitis B, 21 with alcoholic cirrhosis and 1 with schistosomial cirrhosis, were included. Bone marrow was aspirated from poster superior spine. After isolation and purification, the stem cells were transplanted into liver via hepatic artery. The liver function, laboratory parameters and Child-Tureotte-Pugh scores were evaluated in 2,4 and 8 weeks after transplantation. Results At the 4th week after transplantation, the level of albumin was increased obviously from (32.9±5.58) g/L to (38.32±6.45) g/L,whereas the alanine aminotransferase was decreased from (96.92±83.91) U/L to (73.48±18.46)U/L. It was revealed that the prothrombin time was decreased from (16.66±3.91) s to (15.52±3.35) s and fibronegen increased from (2. 22 ± 0. 88) g/L to (2. 58±0. 88) g/L. After transplantation, appetite was improved in 72 cases (92.3%), ascites was decreased in 70 cases (89.7%) and abdomen distention was ameliorated in 68 cases (87.2%). There was no complications related to the transplantation. Conclusion Transplantation of autologous bone marrow stem cells is a safe and effective method in treatment of patients with decompensated cirrhosis.