脐带间充质干细胞与脐血干细胞移植治疗慢性肝功能衰竭对比观察

发布时间：2018-03-18 18:39

本文选题：肝功能衰竭　切入点：脐带间充质干细胞　出处：《山东医药》2017年03期 　论文类型：期刊论文

【摘要】：目的对比观察脐带间充质干细胞与脐血干细胞移植治疗慢性肝功能衰竭(后简称肝衰竭)的疗效。方法慢性肝衰竭患者(乙型肝炎病毒感染进展而来)47例,分为A组25例、B组22例。A、B组在内科综合治疗的基础上分别采用脐带间充质干细胞、脐血干细胞经外周静脉输注治疗。分别于移植前及移植后2、4、12、24周检测两组血清谷丙氨酸转移酶(ALT)、总胆红素(TBIL)、白蛋白(ALB)、凝血酶原活动度(PTA)并进行MELD评分。观察患者临床症状改善情况、干细胞移植后不良反应、肝癌发生情况、患者生存情况。结果两组移植后2、4、12、24周血清ALT、TBIL和MELD评分均较移植前明显降低,ALB和PTA均较移植前明显升高(P均0.05)。干细胞移植4周后,两组乏力、食欲、腹胀及腹水情况均较移植前改善,两组症状改善情况差异无统计学意义。随访至移植后24周,A组生存20例,死亡5例,生存率为80.00%;B组生存18例,死亡4例,生存率81.82%。两组生存率差异无统计学意义。两组在移植及随访过程中均未发现与干细胞治疗相关的不良反应,无肝癌发生。结论脐带间充质干细胞与脐血干细胞移植治疗慢性肝衰竭均可改善患者的肝功能、减轻临床症状且应用较为安全,两种方法疗效相当。
[Abstract]:Objective to compare the therapeutic effects of umbilical cord mesenchymal stem cell transplantation and umbilical cord blood stem cell transplantation in the treatment of chronic liver failure. Group A (25 cases) and group B (22 cases) were treated with umbilical cord mesenchymal stem cells on the basis of comprehensive medical treatment. Umbilical cord blood stem cells were treated by peripheral vein infusion. The serum glutamic alanine transferase (alt), total bilirubin (Tbilirubin), albumin (Alb) and prothrombin activity (MELD) were measured before and 24 weeks after transplantation. Improved bed symptoms, Results the scores of serum alt TBIL and MELD in the two groups were significantly lower than those before transplantation, and the levels of PTA and ALB were significantly higher than those before transplantation (P < 0.05). 4 weeks after transplantation, the scores of alt TBIL and MELD in both groups were significantly higher than those before transplantation. Fatigue, appetite, abdominal distension and ascites were improved in both groups, and there was no significant difference in symptoms between the two groups. After 24 weeks of transplantation, 20 patients in group A survived and 5 died. The survival rate of group B was 80.002%, and the survival rate was 4 cases. The survival rate was 81.82%. There was no significant difference in survival rate between the two groups. No adverse effects associated with stem cell therapy were found in the two groups during transplantation and follow-up. Conclusion both umbilical cord mesenchymal stem cells and umbilical cord blood stem cells transplantation can improve the liver function of patients with chronic liver failure, alleviate clinical symptoms and be used safely.
【作者单位】：河北医科大学第一医院;
【基金】：河北省医学科学研究重点课题(20150636)
【分类号】：R575.3

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