自体骨髓干细胞治疗失代偿期肝硬化的临床观察

侯长利; 尚建中; 赵林华; 王志鹏; 李晓飞; 刘小壮; 张素娥; 范燕峰

自体骨髓干细胞治疗失代偿期肝硬化的临床观察

焦作市第三人民医院

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中图分类号: R575.2
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出版历程
- 出版日期: 2012-05-20

The clinical research on autonomous bone marrow stem cells to treat decompensated cirrhosis

摘要

摘要: 目的观察经肝动脉行自体骨髓干细胞治疗失代偿肝硬化患者的临床疗效及安全性。方法将我科2009年11月～2011年2月的住院乙型肝炎肝硬化失代偿患者50例配对分为2组。治疗组25例,对照组25例。治疗组,抽取自体骨髓200 ml,体外分离纯化骨髓干细胞制成10 ml细胞悬液,经肝动脉注入肝脏,分别在治疗后第4、8、16周观察实验室指标、临床症状体征及不良反应,并与对照组进行比较。结果治疗组治疗后所有患者症状均有不同程度改善,治疗后8周内腹水减轻16例(80%),食欲改善18例(90%),乏力好转19例(95%),腹胀减轻18例(90%)。对照组8周腹水减轻10例(50%),食欲改善12例(60%),乏力好转10例(50%),腹胀减轻8例(40%)。治疗组患者在干细胞治疗后第4周实验室指标开始出现变化,至第8周多项指标出现显著变化,治疗8周和16周时ALT、TBil、白蛋白(Alb)、总胆固醇(CHO)、凝血酶原时间(PT)与治疗前相比差异有统计学意义。治疗组与对照组在8周和16周时,ALT、TBil、PT、CHO各项指标相比,差异均有统计学意义。治疗前后CTP评分及MELD评分变化,从第4...
- 肝硬化 /
- 干细胞移植
Abstract: Objective To evaluate the the clinical efficacy and safety of trans-artery intrahepatic autonomous bone marrow stem cell treatment in patients with decompensated liver cirrhosis. Methods 50 hospitalized patients with decompensated liver cirrhosis in our department from November 2009 to February 2011 were divided into 2 matched groups.There were 25 patients in the treatment group, 25 patients in the control group.Bone marrow 200 ml were extracted from patients in treatment group, and bone marrow stem cells were purified in vitro and made into 10 ml cell suspension, then injected into the liver through the hepatic artery.The laboratory parameters, clinical signs and symptoms of adverse reactions were observed respectively at the 4, 8, 16 weeks after treatment compared with the control group.Results After treatment, all patients' symptoms were improved.After 8 weeks treatment, the symptom of ascites in 16 cases was decreased (80%) , the appetite in 18 cases was improved (90%) , the symptom of fatigue in 19 cases was improved (95%) , the symptom of abdominal distension in 18 cases was alleviated (90%) .After 8 weeks treatment in control group, the symptom of ascites in 10 patients was decreased (50%) , the appetite in 12 cases was having been improved (60%) , the symptom of fatigue in 10 cases was improved (50%) , the symptom of abdominal distension in 8 cases was alleviated (40%) .The laboratory parameters in patients in treatment group were changed after 4 weeks stem cell treatment, to 8 weeks a number of indicators showing significant change.After 8 weeks and 16 weeks treatment, the alanine aminotransferase (ALT) 、Total bilirubin (TBil) 、 albumin (Alb) , 、total cholesterol (CHO) , prothrombin time (PT) show significant difference compared with before treatment.At 8 weeks and 16 weeks in treatment group and control group, the indicators of ALT、Alb、TBil、PT、CHO, were statistically significant.CTP score changes before and after treatment, starting from the 4th week, patients with CTP score dropped significantly.To 8 weeks and 16 weeks, the changes were most obvious, compared with before treatment there was significant difference.Treatment group and control group also had significant differences.MELD score from 4 weeks after treatment began to decline, after treatment 8th week and when 16 week, compared with before treatment there was significant difference, compared with the control group are also significant differences.25 cases did not occur in patients with serious complications, and no adverse reactions appeared recently.Conclusion Autonomous bone marrow stem cell to treat patients with liver failure treatment is effective and clinical, security good, as a means in the clinical treatment of patients with advanced liver cirrhosis.
- liver cirrhosis /
- stem cell transplantation

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参考文献(18)

[1]Peng L, Xie DY, Lin BL, et al.Autologous bone marrowmesenchymal stem cell transplantation in liver failure patientscaused by hepatitis B:Short-term and long-term out-comes[J].Hepatology, 2011, 54:820-828.

[2]Terai S, Sakaida I.Autologous bone marrow cell infusiontherapy for liver cirrhosis patients[J].Gastroenterol Hepa-tol, 2011, 18 (1) :23-25.

[3]Dalakas E, Newsome PN, Boyle S, et al.Bone marrowstem cells contribute to alcohol liver fibrosis in humans[J].Stem Cells, 2010, 19 (9) :1417-1425.

[4]Smets F, Najimi M.Sokal EM.Cell transplantation in thetreatment of liver diseases[J].Pediatr Transplant, 2008, 12 (1) :6-13.

[5]Kharaziha P, Hellstrom PM, Noorinayer B, et al.Improvementof liver function in liver cirrhosis patients after autologous mes-enchymal stem cell injection:a phase I-II clinical trial[J].Gas-troenterol Hepatol, 2009, 21 (10) :1199-1205.

[6]Lyra AC, Soares MB, da Silva LF, et al.Infusion of autologousbone marrow mononuclear cells through hepatic artery results ina short-term improvement of liver function in patients withchronic liver disease:a pilot randomized controlled study.Eur[J].Gastroenterol Hepatol, 2010, 22 (1) :33-42.

[7]Ismail A, Fouad O, Abdelnasser A, et al.Stem cell therapyimproves the outcome of liver resection in cirrhotics[J].JGastrointest Cancer, 2010, 41 (1) :17-23.

[8]王娟, 邵昕春, 郭庆, 等.自体骨髓干细胞治疗治疗失代偿期肝硬化[J].中国组织工程研究与临床康复, 2007, 11 (46) :9395-9397.

[9]何金秋, 潘兴南, 王崇国, 等.自体骨髓间充质干细胞治疗治疗终末期肝病39例[J].中国组织工程研究与临床康复, 2010, 14 (45) :8521-8525.

[10]Jiang YH, Jahagirdar BN, Reinhardt RL, et al.Pluripotencyof mesenchymal stem cells derived from adult marrow[J].Nature, 2002, 418 (6893) :41-49.

[11]中华医学会.慢性乙型肝炎防治指南[J].中华传染病杂志, 2005, 23 (6) :421-431.

[12]Bajek A, Olkowska, Drewa T.Mesenchymal stem cells as atherapeutic tool in tissue and organ regeneration[J].Postepy Hig Med Dosw (Online) , 2011, 24 (65) :24-32.

[13]Amer ME, El-Sayed SZ, El-Kheir WA, et al.Clinical andlaboratory evaluation of patients with end-stage liver cellfailure injected with bone marrow-derived hepatocyte-likecells[J].Gastroenterol Hepatol, 2011, 23 (10) :936-941.

[14]Gilchrist ES, Plevris JN.Bone marrow-derived stem cells inliver repair:10 years down the line[J].Liver Transpl, 2010, 16 (2) :118-129.

[15]Moore KA, Lemischka IR.Stem cells and their niches[J].Science, 2006, 311 (5769) :1880-1885.

[16]Le Blanc K, Pittenger M.Mesenchymal stem cells:progresstoward promise[J].Cytotherapy, 2005, 7 (1) :36-45.

[17]Parekkadan B, van Poll D, Megeed Z, et al.Immunomodulationof activated hepatic stellate cells by mesenchymal stem cells[J].Biochem Biophys Res Commun, 2007, 363 (2) :247-252.

[18]Greenbaum LE, Wells RG.The role of stem cells in liver repairand fibrosis[J].Biochem Cell Biol, 2011, 43 (2) :222-229.

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