脐血干细胞移植治疗慢性肝衰竭患者的临床观察
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摘要
目的:观察脐血干细胞移植治疗慢性肝衰竭患者的安全性及临床疗效。方法:慢性肝衰竭患者44例,其中对照组22例,给予内科综合治疗,治疗组22例,在内科综合治疗的基础上给予脐血干细胞治疗。观察治疗前和治疗后2、4、12、24周生化指标、MELD评分、临床症状、生存情况及不良反应。结果:治疗组白蛋白、凝血酶原活动度较对照组升高,MELD评分较对照组降低,生存率较对照组升高,组间比较有统计学差异(P<0.05);两组丙氨酸转氨酶、总胆红素比较无统计学差异(P>0.05)。治疗4周后,治疗组乏力、食欲、腹胀及腹水情况均较对照组改善,差异有统计学意义(P<0.05)。两组患者均未出现明显不良反应,无肝细胞癌发生。结论:脐血干细胞移植治疗慢性肝衰竭患者安全有效,可明显提高患者生存率。
Objective To observe the safety and clinic effect of umbilical blood stem cell transplantationfor the patients with chronic liver failure(CLF).Methods 44 patients with CLF were included in the research anddivided into two groups,22 in control group received internal medicine treatment,the other 22 in treatment group re-ceived umbilical blood stem cell transplantation in addition to internal medicine treatment.The biochemical index,MELD scores,clinical symptoms,survival situation and adverse reaction of the patients were observed within 2,4,12 and 24 weeks.Results Albumin and prothrombin activity of treatment group were higher than those of controlgroup,the MELD scores of the treatment group was lower than that of control group,the survival rate was higherthan the control group,and the difference is significant between the two groups(P < 0.05).There was no significantdifference between the two groups in terms of alanine aminotransferase and total bilirubin(P > 0.05).After 4 weekstreatment,fatigue,inappetite,abdominal distention and ascitic fluid of the treatment group were better than that ofcontrol group,the difference was statistically significant(P < 0.05).Besides,the patients of the both groups did nothave any adverse reaction or hepatocellular carcinoma.Conclusion Umbilical blood stem cell transplantation issafe and effective for the patients with CLF and can improve the survival rate of the patients.
Objective To observe the safety and clinic effect of umbilical blood stem cell transplantationfor the patients with chronic liver failure(CLF).Methods 44 patients with CLF were included in the research anddivided into two groups,22 in control group received internal medicine treatment,the other 22 in treatment group re-ceived umbilical blood stem cell transplantation in addition to internal medicine treatment.The biochemical index,MELD scores,clinical symptoms,survival situation and adverse reaction of the patients were observed within 2,4,12 and 24 weeks.Results Albumin and prothrombin activity of treatment group were higher than those of controlgroup,the MELD scores of the treatment group was lower than that of control group,the survival rate was higherthan the control group,and the difference is significant between the two groups(P < 0.05).There was no significantdifference between the two groups in terms of alanine aminotransferase and total bilirubin(P > 0.05).After 4 weekstreatment,fatigue,inappetite,abdominal distention and ascitic fluid of the treatment group were better than that ofcontrol group,the difference was statistically significant(P < 0.05).Besides,the patients of the both groups did nothave any adverse reaction or hepatocellular carcinoma.Conclusion Umbilical blood stem cell transplantation issafe and effective for the patients with CLF and can improve the survival rate of the patients.
引文
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[12]ZHANG Y,CAI W,HUANG Q,et al.Mesenchymal stem cellsalleviate bacteria-induced liver injury in mice by inducing regu-latory dendritic cells[J].Hepatology,2014,59(2):671-682.
[13]HIGASHIMOTO M,SAKAI Y,TAKAMURA M,et al.Adiposetissue derived stromal stem cell therapy in murine Con A-derivedhepatitis is dependent on myeloid-lineage and CD4+T-cell sup-pression[J].Eur J Immunol,2013,43(11):2956-2968.
[14]YANG W B,CHEN E Q,BI H X,et al.Different models inpredicting the short-term prognosis of patients with hepatitis Bvirus-related acute-on-chronic liver failure[J].Ann Hepatol,2012,11(3):311-319.
[15]李元元,徐若男,施明,等.人脐带间充质干细胞治疗慢加急性肝衰竭患者的初步临床观察[J].中华细胞与干细胞杂志(电子版),2015,5(1):36-40.
[16]PENG L,XIE D Y,LIN B L,et al.Autologous bone marrowmesenchymal stem cell transplantation in liver failure patientscaused by hepatitis B:short-term and long-term outcomes[J].Hepatology,2011,54(3):820-828.
[2]SHI M,ZHANG Z,XU R,et al.Human mesenchymal stemcell transfusion is safe and improves liver function in acute-on-chronic liver failure patients[J].Stem Cells Transl Med,2012,1(10):725-731.
[3]ZHENG G,LIU Y,JING Q,et al.Differentiation of human um-bilical cord-derived mesenchymal stem cells into hepatocytes invitro[J].Biomed Mater Eng,2015,25(1 Suppl):145-157.
[4]LI J,ZHANG L,XIN J,et al.Immediate intraportal transplan-tation of human bone marrow mesenchymal stem cells preventsdeath from fulminant hepatic failure in pigs[J].Hepatology,2012,56(3):1044-1052.
[5]TANG Y,LI Q,MENG F,et al.Therapeutic potential of HGF-expressing human umbilical cord mesenchymal stem cells inmice with acute liver failure[J].Int J Hepatol,2016,2016:5452487.
[6]张岁,闫宝勇,佟立新,等.脐血干细胞移植治疗乙型肝炎肝硬化的疗效[J].实用医学杂志,2015,31(19):3162-3165.
[7]LI Q,ZHOU X,SHI Y,et al.In vivo tracking and comparisonof the therapeutic effects of MSCs and HSCs for liver injury[J].PLo S One,2013,8(4):e62363.
[8]LI T,ZHU J,MA K,et al.Autologous bone marrow-derivedmesenchymal stem cell transplantation promotes liver regenera-tion after portal vein embolization in cirrhotic rats[J].J SurgRes,2013,184(2):1161-1173.
[9]LIU W H,SONG F Q,REN L N,et al.The multiple function-al roles of mesenchymal stem cells in participating in treatingliver diseases[J].J Cell Mol Med,2015,19(3):511-520.
[10]YOVCHEV M I,XUE Y,SHAFRITZ D A,et al.Repopulationof the fibrotic/cirrhotic rat liver by transplanted hepatic stem/pro-qenitor cells and mature hepatocytes[J].Hepatology,2014,59(1):284-295.
[11]CHAI N L,ZHANG X B,CHEN S W,et al.Umbilical cord-derived mesenchymal stem cells alleviate liver fibrosis in rats[J].World J Gastroenterol,2016,22(26):6036-6048.
[12]ZHANG Y,CAI W,HUANG Q,et al.Mesenchymal stem cellsalleviate bacteria-induced liver injury in mice by inducing regu-latory dendritic cells[J].Hepatology,2014,59(2):671-682.
[13]HIGASHIMOTO M,SAKAI Y,TAKAMURA M,et al.Adiposetissue derived stromal stem cell therapy in murine Con A-derivedhepatitis is dependent on myeloid-lineage and CD4+T-cell sup-pression[J].Eur J Immunol,2013,43(11):2956-2968.
[14]YANG W B,CHEN E Q,BI H X,et al.Different models inpredicting the short-term prognosis of patients with hepatitis Bvirus-related acute-on-chronic liver failure[J].Ann Hepatol,2012,11(3):311-319.
[15]李元元,徐若男,施明,等.人脐带间充质干细胞治疗慢加急性肝衰竭患者的初步临床观察[J].中华细胞与干细胞杂志(电子版),2015,5(1):36-40.
[16]PENG L,XIE D Y,LIN B L,et al.Autologous bone marrowmesenchymal stem cell transplantation in liver failure patientscaused by hepatitis B:short-term and long-term outcomes[J].Hepatology,2011,54(3):820-828.