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1、肝脏2010年4月第15卷第2期81论著脐血干细胞移植治疗肝硬化的疗效观察陈海鸥胡小宣刘洪娟钱林摘要!目的观察脐血干细胞移植治疗失代偿期肝硬化患者的临床疗效。方法失代偿期肝硬化患者34例,其中乙型或丙型肝炎肝硬化22例,乙型肝炎与酒精性混合性肝硬化3例,酒精性肝硬化4例,胆汁性肝硬化4例,肝豆状核变性所致肝硬化1例;ChildPugh分级:A级3例,B级21例,C级10例。所有患者术前均行肝功能及影像学等检查,无菌采取脐血并分离出干细胞,经肝动脉将干细胞悬液移植入肝脏,分别在移植
2、后第1周、1个月、3个月、6个月复查肝功能,观察实验室指标、临床症状及不良反应情况。结果干细胞移植术后大部分患者症状明显改善;术后6个月ALT由均值56.9U/L降至46.3U/L,TBil由47.3mol/L降至24.6mol/L,Alb由30.9g/L上升至35.5g/L,PT由17.9s降至16.4s;术后复查B超仅1例患者腹水增多,15例腹水明显减少,9例腹水消失;34例患者未发现严重不良反应及并发症。结论脐血干细胞移植安全可行,可不同程度改善肝硬化患者临床症状、肝功能和凝血功能。关键词!
3、脐血;干细胞移植;肝硬化ThetherapeuticeffectoftheumbilicalbloodstemcelltransplantationinthepatientswithcirrhosisChenhaiou,Huxiaoxuan,Liuhongjuan,QianlinHepatopathyInternalDepartment,Pepole'sHospitalofHunanProvince,Changsha410006,ChinaAbstract!ObjectiveToinve
4、stigatetheclinicaltherapeuticeffectofumbilicalbloodstemcelltransplantationinpatientswithdecompensatedcirrhosis.MethodsThirtyfourpatientsofdecompensatedcirrhosiswereincluded.Amongthem,twentytwowereviralhepatitiscirrhosis,threewerehepatitisBandalcoholicci
5、rrhosis,fouralcoholiccirrhosis,fourbiliarycirrhosisandonecirrhosiswithWilson'sdisease.Afterisolationandpurification,theumbilicalbloodstemcellsweretransplantedintotheliverviahepaticartery.ThebiochemicalindexofALT,TBil,Alb,PTandclinicalsymptomsweredetectedat
6、differenttimesaftertransplantation(1week,1month,3months,6months).ResultsMostofthepatientshavesignificantimprovementinsymptomsafterthestemcelltransplantation;Atsixmonthaftertransplantation,themeanalanineaminotransferaseleveldecreasedfrom56.9U/Lto46.3U/L,th
7、emeantotalserumbilirubindecreasedfrom47.3mol/Lto24.6mol/L,themeanalbuminlevelincreasedfrom30.9g/Lto35.5g/L,themeanprothrombintimedecreasedfrom17.9sto16.4s.UnderabdominalBultrasonography,ascitesonlyincreasedinonecase,butdecreasedsignificantlyin15casesandd
8、isappearedin9cases.Nosevereadverseeffectandseriouscomplicationoccurred.ConclusionsUmbilicalbloodstemcelltransplantationisfeasibleandsafe,whichcanimproveclinicalsymptoms,liverfunctionandbloodcoagulationfuncti
