自体骨髓干细胞移植治疗终末期肝病56例临床观察

目的：探讨自体骨髓干细胞移植对终末期肝病患者的治疗作用。方法：56例终末期肝病患者无菌采集骨髓，负收集法分离纯化骨髓干细胞，经肝固有动脉注入肝脏。术后观察肝脏储备功能和合成功能，同时观察患者症状体征和不良反应。结果：患者骨髓采集量为120～180ml，分离细胞数为5．8×10^7-9．6×10^8个，与术前比较，术后1周91．6％的患者食欲改善，87．5％的患者体力明显改善；术后12周吲哚氰绿血浆清除率（ICGK）升高，吲哚氰绿15min滞留率（ICGRl5）下降，与术前比较差异有显著性意义（P〈0．05）；血清血蛋白（Alb）在术后4周开始升高，12周达到最高，与治疗前比差异有显著性意义（P〈0．05）；胆碱酯酶（CHE）、凝血酶原时间（PT）移植术后持续改善，12周时较术前增加最明显，差异有显著性意义（P〈0．05）；18例并发腹水者，有11例患者腹水消失，有5例腹水减轻但没有消退。结论：自体骨髓干细胞移植技术治疗终末期肝病，患者肝脏储备功能、合成功能改善明显，术后无不良反应，安全可行。

Therapeutic efficacy of autologous bone marrow stem cells transplantation for treatment of terminal liver disease of 56 cases

Objective： To study the effect of autologous bone marrow stem cells （BMSCs） transplantation in the treatment of terminal liver disease. Methods： Bone marrow were collected from 56 terminal liver disease patients and stem cells were har- vested by negative collecting method. The stem cells were infused into the liver through hepatic artery. At different time points, the patients liver reserving and synthesis function were detected. Symptoms and adverse reactions were observed at the same time. Results： The volume of bone marrow were 120 - 180ml and the number of isolated stem cells were 5.8 ×10^7 -9. 6×10^8. Compared with the pre-transplantation, the appetite of 91.6% patients and the physical strength of 87. 5% patients were im- proved after 1 week. ICGK were significantly increased and ICGRI5 were significantly declined at 12 weeks after transplantation （ P 〈 0. 05 ） . Alb level in serum were significantly increased at 4 weeks and 12weeks after transplantation （ P 〈 0. 05 ） . The se- rum CHE and PT continually were improved, 12 weeks were increased obviously （P 〈0. 05） . In 18 cases complicated with as- cites, the ascites were disappeared in l lcases and were reduced in 5 cases. Conclusion： Autologous bone marrow stem cell transplantation for treatment of terminal liver disease, liver reserving function and synthetic function in patients is improved signif- icantly, and there is no adverse reaction after the operation. Autologous bone marrow stem cell transplantation is safe and feasi- ble.