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脐血干细胞移植治疗重症肝炎效果观察

王志凌,马应杰,韩际奥   

  1. 郑州人民医院消化内科
  • 收稿日期:2013-01-11 修回日期:2013-08-07 出版日期:2013-11-15 发布日期:2013-11-15
  • 通讯作者: 王志凌

The Therapeutic Effects of the Cord Blood Stem Cell Transplantation in Patients with Severe Hepatitis

WANG Zhi ling,MA Ying jie,HAN Ji ’ao   

  1. Department of Digestive System, People’s Hospital of Zhengzhou
  • Received:2013-01-11 Revised:2013-08-07 Published:2013-11-15 Online:2013-11-15
  • Contact: WANG Zhi ling

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摘要：  【摘要】 目的  探讨人脐血干细胞治疗重症肝炎的效果。  方法  将40例重症肝炎患者随机分为对照组20例及观察组20例，2组均采用复方甘草酸苷、还原性谷胱甘肽等常规治疗，观察组同时加用移植脐血干细胞悬液治疗，首次经肝动脉穿刺输入，之后通过周围静脉输注脐血干细胞悬液。监测2组肝功能、白蛋白（ALB）、凝血酶原活动度（PTA）、甲胎蛋白（AFP）等相关指标，观察2组临床症状变化情况，并进行不良反应检测。    结果  治疗后4周时，观察组PTA（%）、AFP（μg/L）较对照组升高     （53.56±5.15vs48.26±5.53，92.16±9.09vs43.57±11.33，P<0.01）；治疗后第8周，观察组丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、AFP低于对照组，PTA高于对照组（62.61±4.35vs54.95±3.01，P<
0.05或P<0.01），2组ALB、血氨差异无统计学意义（P＞0.05）。2组治疗均未发生严重并发症及不良反应，病死率差异无统计学意义（20%vs35%，χ2=0.818，P>0.05）。  结论  脐血干细胞治疗重症肝炎有较好的疗效，且安全、无明显不良反应，可作为重症肝炎患者新的治疗方法。

关键词: 脐血干细胞移植, 甲胎蛋白类, 血清白蛋白, 丙氨酸转氨酶, 重症肝炎

Abstract:

[Abstract]   Objective   To study the effect of the cord blood stem cell transplantation therapy in patients with severe
hepatitis.   Methods    Forty patients with severe hepatitis were randomly divided into control groups (n=20) and observed group (n=20). The patients in two groups were treated with the conventional liver protective therapy respectively, such as compound glycyrrhizin and glutathione. The patients in observed groups were performed with the cord blood stem cell trans?plantation therapy. After isolation and purification, the cells were transplanted into the liver via hepatic artery and then were transplanted via peripheral veins. The biochemical indices of albumin (ALB), prothrombin activity (PTA)，alpha-fetoprotein （AFP）and clinical symptoms were detected at different times after therapy.   Results   After4-week therapy, the levels of PTA（%）and AFP（μg/L）were significantly increased in observed group compared with those of control group (53.56±5.15vs48.26±5.53，92.16±9.09vs43.57±11.33，P<0.01). After8-week therapy, the levels of alanine aminotransferase (ALT), totalbilirubin (TBIL) and AFP were significantly decreased in observed group than those of control group. The level of PTA was sig?nificantly higher in observed group than that of control group (62.61±4.35vs54.95±3.01，P<0.05orP<0.01). There were nosignificant differences in levels of ALB and blood ammonia between two groups (P>0.05). There were no serious complications and adverse reactions in two groups of patients. There was no significant difference in mortality between two groups (20%vs35%,χ2=0.818 P>0.05).   Conclusion   Cord blood stem cell therapy has a good effect on treating severe hepatitis, which is safe and no significant adverse reactions, and can be used as a new method for treating the severe hepatitis.

Key words: cord blood stem cell transplantation, alpha-fetoproteins, serum albumin, alanine transaminase, severe hepatitis