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目的探讨自体骨髓干细胞移植治疗失代偿肝硬化的临床疗效。方法选择12例失代偿期乙肝后肝硬化患者,年龄38～75岁。患者在无菌条件下,从髂后上棘抽取骨髓80～90ml,分离纯化骨髓干细胞,经肝动脉导管注入肝脏。术后定期检测肝功能和凝血功能,并观察临床症状及不良反应情况。结果与术前相比,术后1周所有血清学指标均无显著性改变(P>0.05);术后4周,白蛋白、前白蛋白及胆碱酯酶活性显著性升高(P<0.01,P<0.05),余肝功能和凝血功能指标均无明显变化(P>0.05)。术后1周患者乏力、腹胀开始减轻,食欲好转,术后4周腹水减轻。术中有1例因紧张进食少出现低血糖,经治疗后好转,余均未发现皮疹、发热、抽搐及出血等其它不良反应及并发症。结论自体骨髓干细胞移植治疗后,患者肝功能明显改善,症状好转,表明骨髓干细胞移植对肝衰竭患者的治疗安全有效且不良反应少。
Objective To investigate the clinical efficacy of autologous bone marrow stem cell transplantation in the treatment of decompensated cirrhosis. Methods Twelve patients with decompensated hepatitis B after liver cirrhosis were selected, aged 38-75 years old. Patients under sterile conditions, from the posterior superior iliac spine bone marrow 80 ~ 90ml, isolated and purified bone marrow stem cells, the hepatic artery catheter into the liver. Liver function and coagulation were measured regularly after operation, and clinical symptoms and adverse reactions were observed. Results Compared with preoperative, all the serological indexes did not change significantly at 1 week after operation (P> 0.05). At 4 weeks after operation, albumin, prealbumin and cholinesterase activities increased significantly (P < 0.01, P <0.05). There was no significant change in the remaining liver function and coagulation function (P> 0.05). One week after surgery, the patient was weak, abdominal distention began to decrease, appetite improved, ascites relief after 4 weeks. One case of intraoperative hypoglycemia due to eating less, after treatment improved, I did not find any rash, fever, convulsions and bleeding and other adverse reactions and complications. Conclusion After the transplantation of autologous bone marrow stem cells, the liver function of the patients is improved obviously and the symptoms are improved. It indicates that the bone marrow stem cell transplantation is safe and effective in the treatment of liver failure patients with less adverse reactions.