天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (1): 83-87.doi: 10.11958/58304

• 临床研究 • 上一篇    下一篇

人脐血干细胞经外周静脉移植治疗失代偿期肝硬化的临床研究

张岁， 佟立新， 闫宝勇△， 李全海， 贾蓓， 柳立平， 马文波， 张君   

  1. 河北医科大学第一医院中西医结合肝病诊疗中心(邮编050031)
  • 收稿日期:2015-01-26 修回日期:2015-08-18 出版日期:2016-01-15 发布日期:2016-01-15
  • 通讯作者: △通讯作者 E-mail： yanbaoyong111@163.com E-mail:zhangsui111@126.com
  • 作者简介:张岁 （1982）， 女， 硕士， 主要从事肝病研究
  • 基金资助:
    河北省科技计划项目 （12276102D）

Clinical study of human umbilical cord blood stem cell transplantation via peripheral vein in the treatment of decompensated cirrhosis

ZHANG Sui, TONG Lixin, YAN Baoyong△, LI Quanhai, JIA Bei, LIU Liping, MA Wenbo, ZHANG Jun   

  1. Liver Disease Diagnoses and Treatment Center of Chinese Western Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China
  • Received:2015-01-26 Revised:2015-08-18 Published:2016-01-15 Online:2016-01-15
  • Contact: △Corresponding Author E-mail： yanbaoyong111@163.com E-mail:zhangsui111@126.com

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摘要： 摘要： 目的 探讨人脐血干细胞经外周静脉移植治疗不同程度肝硬化患者的疗效及安全性。方法 失代偿期肝硬化患者 65 例， 分为干细胞组 34 例， 其中 Child-Pugh A 级 13 例、 B 级 14 例、 C 级 7 例， 在常规保肝治疗的基础上给予脐血干细胞移植治疗； 对照组 31 例， 其中 Child-Pugh A 级 11 例、 B 级 13 例、 C 级 7 例， 给予常规保肝治疗。于治疗后 2、 4、 12 及 24 周观察不同程度肝硬化患者肝功能和凝血功能变化， 并观察临床症状改善以及不良反应发生情况。结果 （1） 临床症状改善情况： Child-Pugh A、 B 级患者干细胞组临床症状较对照组明显改善。Child-Pugh C 级患者 2 组临床症状改善程度差异无统计学意义。（2） 肝功能和凝血功能改善情况： Child-Pugh A、 B 级患者干细胞组白蛋白 （ALB）、 凝血酶原活动度 （PTA） 治疗后 2、 4、 12、 24 周均较治疗前升高， 且干细胞组于 12、 24 周均较对照组升高； 干细胞组胆碱酯酶 （CHE） 治疗后 4、 12、 24 周均较治疗前升高， 但与对照组比较差异无统计学意义； 2 组丙氨酸转氨酶 （ALT）、 天冬氨酸转氨酶 （AST）、 总胆红素 （TBIL） 比较差异均无统计学意义。干细胞组 Child-Pugh C 级患者治疗后 ALT、 AST、 TBIL、 ALB、 CHE、 PTA 与治疗前及对照组比较差异均无统计学意义。（3） 所有患者均未发生严重不良反应及并发症。结论 经外周静脉移植脐血干细胞治疗失代偿期肝硬化患者安全有效， Child-Pugh A、 B 级患者的疗效优于 Child-Pugh C 级患者。

关键词: 脐血干细胞移植, 肝硬化, 治疗, 观察

Abstract: Abstract:Objective To investigate the effect and safety of human umbilical cord blood stem cell transplantation via peripheral vein in the treatment of different degrees of liver cirrhosis. Methods Sixty-five patients with liver cirrhosis were selected, and divided into stem cell group (n=34) and control group (n=31). Stem cell group included patients with different degrees of cirrhosis: 13 with Child-Pugh A, 14 with Child-Pugh B and 7 with Child-Pugh C respectively, patients in stem cell group were given intravenous infusion of human umbilical cord blood stem cells via peripheral vein on the basis of rou⁃ tine treatment. The changes of liver function and coagulation function were observed before transplantation, 2, 4, 12 and 24 weeks after transplantation. In addition, clinical symptoms and side effects in patients were observed after the stem cell treat⁃ ment. Results (1) Clinical symptoms were improved obviously in patients with Child-Pugh A and B in stem cell group com⁃ pared with those in control group. There were no significant differences in clinical symptoms in patients with Child-Pugh C between stem cell group and control group. (2) Liver of albumin (ALB), prothrombin activity (PTA) were significantly in⁃ creased in patients with Child-Pugh A and B in stem cell group at 2, 4,12 and 24 weeks after treatment than those before treatment. Levels of ALB and PTA were increased in stem cell group at 12 and 24 weeks after treatment than those of control group. The level of cholinesterase (CHE) was increased in stem cell group at 4, 12 and 24 weeks after treatment than thosebefore treatment. There was no significant differences in level of CHE between stem cells group and control group. There was no significant differences in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) between stem cell group and control group. There were no significant differences in ALT, AST, TBIL, ALB, CHE and PTA in patients with Child-Pugh C between stem cell group and control group. (3) There were no severe complications and adverse reactions in patients after treatment. Conclusion Human umbilical cord blood stem cell transplantation via periph⁃ eral vein is safe and effective for the treatment of liver cirrhosis. The curative effect is much remarkable in patients with Child-Pugh A and B than that in patients with Child-Pugh C.

Key words: cord blood stem cell transplantation, liver cirrhosis, therapy, observation