自体干细胞移植在乙型肝炎肝硬化治疗中的应用

发布时间：2018-10-11 10:44

【摘要】：目的观察自体干细胞移植在乙型肝炎肝硬化治疗中的应用效果。方法将52例乙型肝炎肝硬化患者随机分为观察组27例与对照组25例,两组均给予保肝、降酶、抗病毒治疗,观察组另予自体干细胞移植治疗;分别于治疗前及治疗第28周,观察临床症状体征改善情况,检测外周血T淋巴细胞亚群、炎性因子、肝功能及肝纤维化指标,并行Child-Pugh评分、终末期肝病模型评分,记录不良反应情况。结果治疗后观察组腹水减轻、下肢水肿缓解、纳差消失、乏力减轻及腹胀缓解比例均高于对照组(P均0.05)。两组各检测指标及评分比较,差异均无统计学意义;与治疗前比较,治疗后两组外周血T淋巴细胞亚群中CD3+、CD4+细胞比例及CD4+/CD8+值升高而CD8+细胞比例降低,炎性因子、肝功能及肝纤维化指标水平及Child-Pugh评分、终末期肝病模型评分均降低(P均0.05),且观察组较对照组变化更明显(P均0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义。结论应用自体干细胞移植治疗乙型肝炎肝硬化可缓解临床症状,改善免疫功能,降低外周血炎性因子水平,改善肝脏功能及疾病预后。
[Abstract]:Objective to observe the effect of autologous stem cell transplantation in the treatment of hepatitis B cirrhosis. Methods 52 patients with hepatitis B cirrhosis were randomly divided into observation group (n = 27) and control group (n = 25). To observe the improvement of clinical symptoms and signs, to detect the peripheral blood T lymphocyte subsets, inflammatory factors, liver function and hepatic fibrosis index, Child-Pugh score, end-stage liver disease model score, and record the adverse reactions. Results after treatment, the rates of ascites, edema, anorexia, fatigue and abdominal distension in the observation group were higher than those in the control group (P 0.05). There was no significant difference in each index and score between the two groups. Compared with before treatment, the ratio of CD3, CD4 cells and CD4 / CD8 in peripheral blood T lymphocyte subsets of the two groups increased, but the proportion of CD8 cells decreased, and inflammatory factors were found in the two groups. The liver function, hepatic fibrosis index level, Child-Pugh score and end-stage liver disease model score were all decreased (P 0.05), and the changes were more obvious in the observation group than in the control group (P 0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion autologous stem cell transplantation can relieve clinical symptoms, improve immune function, decrease the level of peripheral blood inflammatory factors and improve liver function and prognosis of hepatitis B cirrhosis.
【作者单位】：郑州大学附属医院南阳市中心医院;南阳医学高等专科学校;
【基金】：河南省卫生厅科研成果项目(宛科鉴字2012第103号99)
【分类号】：R512.62;R575.2

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