摘要
目的:探索自体骨髓干细胞移植对肝衰竭患者的治疗作用,为干细胞移植的临床应用研究提供基础。方法:我们选择60例慢性重症肝病患者来源于我所住院患者,年龄在20～65岁;患者在无菌条件下,从骼后上棘抽取骨髓5～100ml,分离纯化骨髓干细胞。在局部麻醉下,行肝动脉介入将分离的骨髓干细胞移植肝脏;患者在移植后不同时间,1周、2周、4周、8周、12周进行肝功能检测;观察在移植后不同时间症状改善情况及术后的不良反应情况。结果:我们发现在移植12周后,谷丙转氨酶(ALT)逐渐降低,由平均136.34IU/L降至59.55IU/L;总胆红素(TBIL),由平均122.88umol/L降至81.58umol/L;白蛋白(ALB)逐渐升高,由平均27.53g/L升至32.13g/L;在干细胞移植后PTA逐渐上升,由术前平均26.33%上升至术后12周的53.48%;移植治疗后患者血氨水平由术前平均151.14Nug/dL下降为术后12周109.0Nug/dl。而治疗后12周内食道静脉曲线未见明显改变。我们进一步观察了自体骨髓干细胞移植后患者的生存情况,发现,患者在移植1周生存率为100%;1例在4周内死亡,生存率为98%;3例在12周内死亡,生存率为95%。我们还发现移植后大多数患者有明显的症状改善,移植后12周食欲改善的45例(75%);体力好转32例(53.3%);腹胀减轻28例(46.6%);在60例移植患者中未发现严重并发症。结论:自体骨髓干细胞移植治疗后,患者肝功能逐步改善。患者凝血机制亦有所改善。症状好转,表明骨髓干细胞移植对肝衰竭患者的治疗有效且副作用小,安全。
Objective：Recent advances have implicated that bone marrow-derived stem cells could differentiation into hepatoeytes and play a important role in the regulation of liver regeneration. In this study we discusse the possibility of treatment for patients with liver failure by transplantation of self-bone marrow derived stem cells inhuman. Metods： Bone marrow was harvested（50 - 100 ml） from patients in the transplant group. To get the bone marrow stem cells（ BMSC）, bone marrow was processed by density gradient sedimentation use Percoll,the final preparation of BMSC were infused into liver of patients via liver artery. At different time （ lweek, 4weeks, 8weeks, 12weeks ） after transplantatio, NALT, TBIL, ALB,PTA were detected,and the survival rate and improve of symptom were investigated. Results：Our results show that after transplantation of bone marrow stem cells, the liver function of patients was improved. 12 weeks after transplantation, the ALT reduced from 136.34 IU/L to 59.55 IU/L;TBIL frome 122.88 umol/L to 81.58 umol/L;ALB were rise from 27.53 g/L to 32.13 g/L;The PTA rise from 26.33% to 53.48% ;The blood NH4 reduced from 151.14 N-ug/dL to 109. 0 N-ug/dL;12 weeks after transplantation,The survival rate of transplant group were 95% ;the symptoms of patients with transplant of BMSC were better. 12 weeks after transplantation, appetite better in 45 cases （75%） , physical strength improve in 32 cases （53.3%） ;abdomen swelling better in 28 cases （46.6%） ;no correlative serious events were found in 60 patients with bone marrow stem ceils transplantation. Conclusion：The liver function of patients with serious liver disēase were improved after bone marrow stem ceils transplantation,the treatment of bone marrow stem ceils transplantation is safe and effective.
出处
《透析与人工器官》
2006年第1期18-21,共4页
Chinese Journal of Dialysis and Artificial Organs
关键词
人
骨髓
干细胞
移植
肝衰竭
Liver Bone marrow stem cells Transplantation Human
