中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2012年
4期
204-208
,共5页
林沪%张政%施明%徐若男%福军亮%李元元%于双杰%陈黎明%吕飒%王福生
林滬%張政%施明%徐若男%福軍亮%李元元%于雙傑%陳黎明%呂颯%王福生
림호%장정%시명%서약남%복군량%리원원%우쌍걸%진려명%려삽%왕복생
肝硬化%脐血干细胞移植%腹水
肝硬化%臍血榦細胞移植%腹水
간경화%제혈간세포이식%복수
Liver cirrhosis%Cord blood stem cell%Ascites
目的 评价人脐带间充质干细胞(UC-MSC)治疗失代偿性肝硬化腹水患者随访1年的临床疗效.方法 采用前瞻性、对照、单盲方法,将解放军第三○二医院肝病生物治疗研究中心收治的54例肝硬化腹水患者分为治疗组38例和对照组16例,分别接受UC-MSC (0.5～1.0)×106/kg和0.9％氯化钠溶液静脉回输,每月1次,共3次.检测并比较不同时间点两组患者的肝功能、HBV DNA、腹部B型超声检测下腹部腹水变化、终末期肝病评分模型(MELD).组间比较采用非参数Mann-Whitney U检验,回输前后数据比较采用Wilcoxon符号秩和检验.结果 UC-MSC回输后,两组间不同时间点ALT、TBil、胆碱酯酶、HBV DNA阳性率以及MELD评分比较,差异均无统计学意义(均P＞0.05)；但治疗组患者在回输36周以后血A1b显著升高,治疗前为(28.47±4.45) g/L,48周为(34.82±4.50) g/L(P=0.046);下腹腹水量显著减少,治疗前为(46.6±30.6)mm,48周为(6.6±13.6)mm,随访结束时与相应对照组比较,均差异有统计学意义(P=0.037).结论 人UC-MSC静脉回输治疗肝硬化腹水患者能升高A1b水平,减少腹水生成,具有良好的临床应用前景.
目的 評價人臍帶間充質榦細胞(UC-MSC)治療失代償性肝硬化腹水患者隨訪1年的臨床療效.方法 採用前瞻性、對照、單盲方法,將解放軍第三○二醫院肝病生物治療研究中心收治的54例肝硬化腹水患者分為治療組38例和對照組16例,分彆接受UC-MSC (0.5～1.0)×106/kg和0.9％氯化鈉溶液靜脈迴輸,每月1次,共3次.檢測併比較不同時間點兩組患者的肝功能、HBV DNA、腹部B型超聲檢測下腹部腹水變化、終末期肝病評分模型(MELD).組間比較採用非參數Mann-Whitney U檢驗,迴輸前後數據比較採用Wilcoxon符號秩和檢驗.結果 UC-MSC迴輸後,兩組間不同時間點ALT、TBil、膽堿酯酶、HBV DNA暘性率以及MELD評分比較,差異均無統計學意義(均P＞0.05)；但治療組患者在迴輸36週以後血A1b顯著升高,治療前為(28.47±4.45) g/L,48週為(34.82±4.50) g/L(P=0.046);下腹腹水量顯著減少,治療前為(46.6±30.6)mm,48週為(6.6±13.6)mm,隨訪結束時與相應對照組比較,均差異有統計學意義(P=0.037).結論 人UC-MSC靜脈迴輸治療肝硬化腹水患者能升高A1b水平,減少腹水生成,具有良好的臨床應用前景.
목적 평개인제대간충질간세포(UC-MSC)치료실대상성간경화복수환자수방1년적림상료효.방법 채용전첨성、대조、단맹방법,장해방군제삼○이의원간병생물치료연구중심수치적54례간경화복수환자분위치료조38례화대조조16례,분별접수UC-MSC (0.5～1.0)×106/kg화0.9％록화납용액정맥회수,매월1차,공3차.검측병비교불동시간점량조환자적간공능、HBV DNA、복부B형초성검측하복부복수변화、종말기간병평분모형(MELD).조간비교채용비삼수Mann-Whitney U검험,회수전후수거비교채용Wilcoxon부호질화검험.결과 UC-MSC회수후,량조간불동시간점ALT、TBil、담감지매、HBV DNA양성솔이급MELD평분비교,차이균무통계학의의(균P＞0.05)；단치료조환자재회수36주이후혈A1b현저승고,치료전위(28.47±4.45) g/L,48주위(34.82±4.50) g/L(P=0.046);하복복수량현저감소,치료전위(46.6±30.6)mm,48주위(6.6±13.6)mm,수방결속시여상응대조조비교,균차이유통계학의의(P=0.037).결론 인UC-MSC정맥회수치료간경화복수환자능승고A1b수평,감소복수생성,구유량호적림상응용전경.
Objective To evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell (UC-MSC) transplantations in decompensated liver cirrhosis patients with ascites.Methods Fifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group (n=38) and control group (n=16) in a prospective controlled single-blinded trial.UC-MSC (0.5-1.0) × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group,respectively.The liver function,hepatitis B virus (HBV) DNA level,ascites and the model for end-stage liver disease(MELD)scores at different time points were compared between two groups.The comparison between groups was done by Mann-Whitney U test,and the data before and after transplantations were compared by Wilcoxon signed rank sum test.Results There were no significant differences of alanine transaminase (ALT),total bilirubin (TBil),cholinesterase (CHE),HBV DNA positive rate and MELD scores at different time points between two groups (P＞0.05).However, the albumin ( A1b) level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were (28.47±4.45) g/L at week 0 and ( 34.82±4.50) g/L at week 48 (P=0.046). Meanwhile, the ascites reduced markedly in treatment group with (46.6 ±30.6) mm at week 0 and (6.6±13.6) mm at week 48,which were significantly different from control group at the end of follow-up (P =0.037). Conclusion UC-MSC transplantations may help to increase A1b level and reduce ascites in patients with decompensated liver cirrhosis.
