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脐带血干细胞移植治疗非肝炎后肝硬化的临床研究

杨彦林   

  1. 河北省衡水市哈励逊国际和平医院
  • 收稿日期:2011-12-29 修回日期:2012-06-07 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 杨彦林

The clinical research of umbilic cord blood stem cell transplantation in non-posthepatitic cirrhosis

  • Received:2011-12-29 Revised:2012-06-07 Published:2013-01-15 Online:2013-01-15

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摘要：

【摘要】 目的探讨脐带血干细胞经肝动脉灌注移植治疗非肝炎后肝硬化的临床疗效。方法 12例非肝炎后肝硬化失代偿期患者,经肝动脉灌注人脐带血干细胞悬液10～15mL,术前1周,术后1周、1个月及3个月观察丙氨酸转氨酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)、纤维蛋白原(FIB)水平变化,同时观察临床症状及体征的改善情况。结果所有患者均顺利移植,患者术后3个月时纳差、乏力、腹胀、腹水均较术前明显改善(P<0.05或P<0.01);患者ALT术后1周较术前升高,术后1个月时下降至术前水平,术后3个月时较术前明显降低。ALB术后1周较术前轻度降低,术后1个月时升至术前水平,术后3个月时较术前明显升高但仍低于正常值(35～50g/L)。TBIL术后1周时均值较术前有所升高,但差异无统计学意义,术后1个月时降至术前水平,术后3个月时较术前明显减低(P<0.05)。血浆FIB术后1周较术前稍有降低,但差异无统计学意义,术后1个月时升至术前水平,术后3个月时较术前明显升高,但仍低于正常值(2～4g/L)。结论脐带血干细胞经肝动脉灌注移植治疗非肝炎后肝硬化安全可靠,近期疗效显著。 

关键词: 干细胞, 脐带血, 非肝炎后肝硬化, 肝动脉, 移植, 介入放射学

Abstract: 【Abstract】 Objective: To evaluate and assess the efficacy of umbilic cord blood stem cell transplantation through hepatic artery in the therapy of patients with non-posthepatitic cirrhosis. Methods: 10-15ml umbilic cord blood stem cells were transplanted into the liver through hepatic artery in 12 patients with non-posthepatitic cirrhosis. Alanine aminotransferase(ALT), albumin(ALB), total bilirubin(TB) and fibrinogen(FIB) were observed at pre-transplantation,1 week ,1 month and 3 months after transplantation were measured and analyzed. Results: All patients were transplanted successfully. The symptoms such as anorexia, fatigue,and distension/ascites begun improved at 1 week post-transplantation and showed significant improvement at 3 months post-transplantation （P＜0.05）.ALT increased at 1 week post-transplantation compared with pre-transplantation （P＜0.01）,while ALB decreased slightly at 1 week after transplantation（P＜0.05）, TB showed insignificant increase after transplantation（P＞0.05）, while FIB decreased insignificantly at the same time（P＞0.05）.All variable resumed to pre-transplantation level at 1month post-transplantation（P＞0.05）.There was significant improvement 3 months after transplantation（P＜0.05）,but the level of ALB and FIB were still under the lower limit. No severe effect and serious complication occurred. No occupying lesions was detected in liver by CT or B-ulreasound at 3 month post-transplantation. Conclusion: The transplantation of umbilic cord blood stem cell through hepatic artery in therapy of patients with non-posthepatitic cirrhosis was a safe and recommendable method with creditable short-term efficacy，but still need further research.

Key words: stem cell, umbilic cord blood, non-posthepatitic cirrhosis, hepatic artery, transplantation, interventional radiology.