CAJ | 학술논문

　　目的比较经门静脉和肝动脉移植脐带血干细胞治疗失代偿期肝硬化患者的疗效与安全性。方法失代偿期肝硬化患者60例被随机分为门静脉治疗组30例和肝动脉治疗组30例。在基础治疗基础上，经皮经肝门静脉穿刺或经股动脉穿刺至肝固有动脉，注入相同数量的脐带血干细胞。观察两组患者临床症状改善情况及术后不良反应；治疗后8周检测血清ALT、AST、总胆红素、凝血酶原活动度和白蛋白水平。结果两组治疗后第3天全部患者乏力、纳差症状均改善，且两组间均未发现严重的不良反应及并发症；移植治疗后8周，门脉组和肝动脉组血清白蛋白分别升高至36.4±7.8g/L和37.1±9.1g/L，PTA分别上升至57.2±11.8%和55.6±12.5%，而ALT、AST、TBIL、AFP在门脉组分别为46.2±14.6IU/L、53.6±15.4IU/L、30.1±12.0μmol/L、13.2±2.8μg/L，在肝动脉组分别为48.2±10.8IU/L、50.2±13.8IU/L、32.1±10.2μmol/L、16.0±3.0μg/L，两组间观察指标在基线水平、变化值和观察终点水平差异均无显著意义。结论经门静脉和肝动脉移植脐带血干细胞治疗失代偿期肝硬化患者有一定的疗效，且安全可行，两种移植治疗近期疗效无显著性差异。
　　목적비교경문정맥화간동맥이식제대혈간세포치료실대상기간경화환자적료효여안전성。방법실대상기간경화환자60례피수궤분위문정맥치료조30례화간동맥치료조30례。재기출치료기출상，경피경간문정맥천자혹경고동맥천자지간고유동맥，주입상동수량적제대혈간세포。관찰량조환자림상증상개선정황급술후불량반응；치료후8주검측혈청ALT、AST、총담홍소、응혈매원활동도화백단백수평。결과량조치료후제3천전부환자핍력、납차증상균개선，차량조간균미발현엄중적불량반응급병발증；이식치료후8주，문맥조화간동맥조혈청백단백분별승고지36.4±7.8g/L화37.1±9.1g/L，PTA분별상승지57.2±11.8%화55.6±12.5%，이ALT、AST、TBIL、AFP재문맥조분별위46.2±14.6IU/L、53.6±15.4IU/L、30.1±12.0μmol/L、13.2±2.8μg/L，재간동맥조분별위48.2±10.8IU/L、50.2±13.8IU/L、32.1±10.2μmol/L、16.0±3.0μg/L，량조간관찰지표재기선수평、변화치화관찰종점수평차이균무현저의의。결론경문정맥화간동맥이식제대혈간세포치료실대상기간경화환자유일정적료효，차안전가행，량충이식치료근기료효무현저성차이。
Objective To determine and compare the short-term efficacy and safety of umbilical cord blood stem cells transplantation through portal vain or hepatic artery in patients with decompensated cirrhosis. Methods Sixty de-compensated cirrhotic patients were injected with umbilical cord blood stem cells via portal vein (portal vein group,n=30)or hepatic artery (hepatic artery group,n=30). The improvement in clinical symptoms and adverse events were observed. Changes in serum levels of AST,ALT,total bilirubin,prothrombin activity,albumin and al-pha fetoprotein after 8 weeks of cell transplantation were determined. Results No differences in the improvement of clinical symptoms such as fatigue and poor appetite were found between the two groups,nor were in adverse events. After 8 weeks of transplantation,the serum albumin increased to 36.4±7.8g/L in portal vein group and 37.1± 9.1g/L in hepatic artery group. The prothrombin time activity increased to 57.2±11.8% and 55.6±12.5%,respec-tively. However,ALT,AST,total bilirubin and alpha fetoprotein decreased to 46.2±14.6IU/L,53.6±15.4 IU/L,30.1± 12.0μmol/L,13.2 ±2.8μg/L in portal vein group respectively,and to 48.2 ±10.8IU/L,50.2 ±13.8 IU/L,32.1 ±10.2μmol/L, 16.0 ±3.0μg/L in hepatic artery group respectively. Conclusion Injection of umbilical cord blood stem cells through portal vein or hepatic artery might have similar efficacy and safety in decompensated cirrhotic patients.