人脐带血干细胞经外周静脉、肝动脉移植治疗失代偿期肝硬化的患者近期疗效观察

发布时间：2018-07-27 14:18

【摘要】：目的比较人脐带血干细胞经外周静脉、肝动脉移植治疗失代偿期肝硬化的患者近期疗效。方法将该院2010年1月-2014年4月收治的40例肝硬化失代偿期患者随机分成两组,每组20例。在内科综合治疗的基础上,分别经外周静脉和经股动脉穿刺至肝固有动脉,移植相同数量的人脐带血干细胞,观察两组患者术后临床症状变化,检测术后2、4、8和12周患者血清总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清蛋白(ALB)、胆碱酯酶(CHE)、凝血酶原时间(PT)水平。结果两组在治疗后2周左右患者临床症状改善,术后4周两组总胆红素、ALT、AST开始逐渐下降,血清白蛋白、胆碱酯酶逐渐上升,凝血酶原时间缩短,与术前比较差异有统计学意义。但外周静脉移植组各检测指标在术后8周与术后12周比较差异无统计学意义。经肝动脉组患者总胆红素、ALT、AST、血清白蛋白等指标改善呈时间依赖性,至术后12周时最明显,而凝血酶原时间术后8周和12周差异无统计学意义。结论经外周静脉、肝动脉移植人脐带血干细胞治疗肝硬化失代偿期患者近期疗效确切,且经肝动脉移植人脐带血干细胞有时间依赖性。
[Abstract]:Objective to compare the short-term effect of human umbilical cord blood stem cell transplantation via peripheral vein in the treatment of decompensated cirrhosis. Methods from January 2010 to April 2014, 40 patients with decompensated cirrhosis were randomly divided into two groups, 20 patients in each group. On the basis of comprehensive medical treatment, the same number of human umbilical cord blood stem cells were transplanted into the proper hepatic artery via peripheral vein and femoral artery respectively. The clinical symptoms of the two groups were observed after operation. Serum total bilirubin (TBIL), glutamate-alanine aminotransferase (ALT),) and serum (ALB), cholinesterase (CHE),) prothrombin time (PT) were measured at 2 and 12 weeks after operation. Results after 2 weeks of treatment, the clinical symptoms of the two groups were improved, the total bilirubin and alt AST began to decrease gradually, the serum albumin and cholinesterase increased gradually, the prothrombin time was shortened, and there was a significant difference between the two groups. However, there was no significant difference between 8 weeks and 12 weeks after operation in peripheral vein transplantation group. The improvement of total bilirubin alt AST and serum albumin in transhepatic artery group was time-dependent and was most obvious at 12 weeks after operation but there was no significant difference in prothrombin time between 8 and 12 weeks after operation. Conclusion Transplantation of human umbilical cord blood stem cells via peripheral vein and hepatic artery is effective in the treatment of patients with decompensated cirrhosis in the short term, and the transplantation of human umbilical cord blood stem cells through hepatic artery is time-dependent.
【作者单位】：南华大学附属第二医院消化内科;南华大学附属第二医院重症医学科;
【分类号】：R575.2

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