摘要
目的:多角度评价不同病因、不同程度肝硬化经肝动脉自体骨髓干细胞移植治疗的临床疗效.方法:回顾分析南华大学附属南华医院就诊的不同病因、不同程度的失代偿期肝硬化患者12例,其中乙型肝炎后肝硬化8例,酒精性肝硬化2例,隐源性肝硬化2例,Child-Pugh:B级4例,C级8例.经肝动脉自体骨髓干细胞移植治疗后观察患者乏力,纳差,腹胀等证状的改善情况,并于术后2、4、8wk复查肝功能和凝血功能,从不同角度分析经肝动脉自体骨髓干细胞移植对肝硬化的治疗效果.结果:患者12例手术成功率为100%,无特殊不良反应及并发症.移植后2、4、8wk,ALT及AST均下降,TBIL由治疗前平均47.68μmol/L±19.80μmol/L在4wk下降至36.45μmol/L±20.78μmol/L,ALB在移植术后2wk由术前的18.79g/L±7.02g/L上升至25.67g/L±5.33g/L.PT及PTA在术后2wk有明显改善(P<0.05),但在4wk及8wk其改善程度不具有统计学意义(P>0.05).2、4wk时总有效率均为83.33%,8wk为66.67%.2、4wk酒精性及隐源性肝硬化患者TBIL及ALB的改善情况优于乙型肝炎后肝硬化.Child-PughB级患者的移植术8wk有效率为100%,Child-PughC级为50%.结论:经肝动脉自体骨髓干细胞移植对肝硬化患者的治疗总体上具有一定的改善作用,对酒精性及隐源性肝硬化患者的疗效优于乙型肝炎后肝硬化,并且肝硬化的程度越轻,疗效越好.
AIM： To evaluate the efficacy and feasibility of autologous bone marrow stem cell transplantation via the hepatic artery in the treatment of different types and degrees of cirrhosis.METHODS： Twelve patients with different types and degrees of decompensated cirrhosis, includ-ing 8 with hepatitis B-associated cirrhosis, 2 with alcoholic cirrhosis, and 2 with cryptogenic cirrhosis, were investigated retrospectively. Of all the patients, 4 had Child-Pugh grade B cirrhosis and 8 had grade C disease. At 2, 4 and 8 weeks after transplantation, the changes in symptoms （acratia, anorexia and abdominal distension）, liver function and coagulation function were observed to analyze the effi cacy and feasibility of autologous bone marrow stem cell transplan-tation via the hepatic artery in the treatment of cirrhosis. RESULTS： Successful transplantation was achieved in all the 12 patients without obvi-ous complications. The levels of plasma ALT and AST decreased after transplantation. TBIL decreased from 47.68 μmol/L ± 19.8 μmol/L at pretreatment to 36.45 μmol/L ± 20.78 μmol/L at 4 wk post-transplantation. Albumin increased from 18.79 g/L ± 7.02 g/L at pretreatment to 25.67 g/L ± 5.33 g/L at 2 wk. Although PT and PTA showed obvious improvement at 2 wk （P 0.05）, no significant improvement was noted at 4 and 8 wk （both P 0.05）. The total effective rate was 83.33% and 83.33% at 2 and 4 wk, respectively, but decreased to 66.67% at 8 wk. The improvement of TBIL and ALB in patients with alcoholic and cryptogenic cirrhosis at 2 and 4 wk was better than that in patients with hepatitis B-associated cirrhosis. The effective rate in patients with Child-Pugh B disease at 8 wk was significantly higher than that in patients with Child-Pugh C disease （100% vs 50%, P 0.05）. CONCLUSION： Autologous bone marrow stem cell transplantation via the hepatic artery can improve hepatic cirrhosis, especially in patients with alcoholic or cryptogenic cirrhosis and those with a mild degree of cirrhosis.
出处
《世界华人消化杂志》
CAS
北大核心
2010年第21期2274-2278,共5页
World Chinese Journal of Digestology
关键词
骨髓干细胞
移植
肝硬化
Bone marrow stem cells
Transplanta-tion
Cirrhosis
