自体骨髓干细胞移植治疗失代偿期肝硬化的初步观察

【目的】评价自体骨髓干细胞移植治疗失代偿期肝硬化的近期临床疗效。【方法】肝硬化失代偿期患者21例,抽取自体骨髓140~200 ml,在体外分离纯化骨髓干细胞制成10~20 ml细胞悬液,经肝动脉介入移植入肝脏,分别在移植后第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情况。【结果】移植后第12周,血清学指标如谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、凝血酶原时间(PT)较术前均有明显降低(P<0.05),胆碱酯酶(CHE)、白蛋白(ALB)较术前增高(P<0.05)。自体骨髓干细胞移植对肝硬化失代偿期患者症状、体征的影响:腹水减少、下肢浮肿减轻、尿黄减轻皆为8/10例;食欲改善、乏力好转皆为13/21例;腹胀减轻15/21例。21例患者术中未发生严重并发症,有1例半年后出现胰腺癌,1年后死亡。【结论】自体骨髓干细胞移植治疗可使肝硬化失代偿期患者肝脏功能明显改善,治疗安全有效且副作用小,为中晚期肝硬化患者提供又一种临床治疗方法。

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

Objective] To explore the clinical effect of autologous bone marrow stem cell transplantation in the treatment of decompensated cirrhosis. Methods] Autologous bone marrow （140 - 200 ml） was respectively extracted from 21 patients with decompensated cirrhosis. After isolation and purification, the stem cells suspension （10 - 20 ml） was respectively transplanted into the liver via hepatic arteries. At 4th, 8th and 12th week, liver function was rechecked, and laboratory indexes, clinical symptoms and untoward effect were recorded. Results] Compared with the preoperative indexes, serological markers （at 12th week） such as ALT, AST, TBIL and PT decreased significantly （P 〈 0.05）, while CHE and ALB increased obviously （P 〈 0.05）. Influence of the transplantation on symptoms and physical signs was as follows. Ascites, lower extremity edema and yellow urine were alleviated in 8 cases of 10, appetite and fatigue were both improved in 13 cases of 21, abdominal distention was alleviated in 15 cases of 21. There were no serious complications in all the 21 patients but 1.5 years later, pancreatic cancer was found in one patient who died another one year later. Conclusions] Transplantation of autologous bone marrow stem cells could greatly improve the liver function of patients with decompensated cirrhosis, so this method was safe and effective in the treatment of patients with advanced cirrhosis.