CAJ | 학술논문

比较经肝动脉途径注入自体骨髓干细胞或脐带血干细胞治疗失代偿期肝硬化患者的安全性，以及对患者肝功能和凝血酶原活动度的近期改善作用。方法选择失代偿期肝硬化患者65例，随机分为骨髓组33例和脐血组32例；骨髓组患者经股动脉插管至肝固有动脉注入自体骨髓干细胞移植治疗，脐血组经同样途径注入脐带血干细胞治疗；治疗后8周检测血清谷丙转氨酶、总胆红素、凝血酶原活动度、白蛋白和甲胎蛋白水平变化，同时观察临床症状的改善情况及术后的不良反应。结果治疗后第3天两组患者乏力、纳差症状均有改善，两组间差异无显著性。治疗后8w，骨髓组和脐血组白蛋白水平分别由（31.0±4.6） g/L 上升至（34.6±7.1）g/L和由（34.6±7.1） g/L上升至（37.8±8.3） g/L，凝血酶原活动度上升由（48.8±13.4）%上升至（55.5±11.2）%和由（47.5±12.5）上升至（58.9±14.0）%，但两组间改善程度的差异无显著性；在治疗8w末血清谷丙转氨酶、总胆红素和甲胎蛋白在骨髓组分别为（45.6±12.3） IU/L、（28.1±13.5）μmol/L和（11.3±4.1）μg/L，在脐血组分别为（47.2±11.8） IU/L、（30.7±14.8）μmol/L和（9.8±3.5）μg/L，两组间与基础水平相比改善程度的差异也无显著性。结论自体骨髓干细胞或脐带血干细胞经肝动脉途径移植治疗失代偿期肝硬化患者的近期疗效及安全性均良好，但两种细胞治疗的改善水平无显著差异。
비교경간동맥도경주입자체골수간세포혹제대혈간세포치료실대상기간경화환자적안전성，이급대환자간공능화응혈매원활동도적근기개선작용。방법선택실대상기간경화환자65례，수궤분위골수조33례화제혈조32례；골수조환자경고동맥삽관지간고유동맥주입자체골수간세포이식치료，제혈조경동양도경주입제대혈간세포치료；치료후8주검측혈청곡병전안매、총담홍소、응혈매원활동도、백단백화갑태단백수평변화，동시관찰림상증상적개선정황급술후적불량반응。결과치료후제3천량조환자핍력、납차증상균유개선，량조간차이무현저성。치료후8w，골수조화제혈조백단백수평분별유（31.0±4.6） g/L 상승지（34.6±7.1）g/L화유（34.6±7.1） g/L상승지（37.8±8.3） g/L，응혈매원활동도상승유（48.8±13.4）%상승지（55.5±11.2）%화유（47.5±12.5）상승지（58.9±14.0）%，단량조간개선정도적차이무현저성；재치료8w말혈청곡병전안매、총담홍소화갑태단백재골수조분별위（45.6±12.3） IU/L、（28.1±13.5）μmol/L화（11.3±4.1）μg/L，재제혈조분별위（47.2±11.8） IU/L、（30.7±14.8）μmol/L화（9.8±3.5）μg/L，량조간여기출수평상비개선정도적차이야무현저성。결론자체골수간세포혹제대혈간세포경간동맥도경이식치료실대상기간경화환자적근기료효급안전성균량호，단량충세포치료적개선수평무현저차이。
Objective To investigat e the safety of autologous bone marrow stem cells or umbilical cord blood stem cells transplantation in treatment of patients with decompensated cirrhosis through hepatic artery and the improvement in liver function and prothrombin activity in a short term. Methods Sixty-five patients with decompensated cirrhosis were randomly divided into bone marrow group(33 cases) and umbilicus cord blood group (32 cases);patients in bone marrow group received autologous bone marrow stem cells transplantation through hepatic artery and the umbilicus cord blood group received umbilical cord blood stem cells through the same way;the changes of serum alanine aminotransferase,total bilirubin,prothrombin activity,albumin and alpha -fetoprotein after 8 weeks were determined,and the improvement in symptoms and postoperative adverse reactions were observed. Results Three days after cell transplantation,patients in both groups achieved significantly improvement in symptom such as fatigue and anorexia but had no significantly difference between the two groups. At eight weeks post therapy,in patients of bone marrow group and umbilicus group,serum albumin level increased significantly from the baseline of (31.0±4.6) g/L to (34.6±7.1)g/L and(26.6±8.0)g/L to(37.8±8.3)g/L,prothrombin activity from (48.8±13.4)% to (55.5±11.2)% and(47.5±12.5) to(58.9±14.0)%,but the improvement did not differ between the two groups;alanine aminotransferase,total bilirubin and alpha-fetoprotein were (45.6 ±12.3) IU/L,(28.1 ±13.5)μmol/L and (11.3 ±4.1)μg/L respectively in patients of bone marrow group and (47.2 ±11.8) IU/L,(30.7 ±14.8)μmol/L and (9.8 ±35) μg/L respectively in patients of umbilical group at 8 weeks post therapy,but the improvement did not differ between groups. Conclusions It is safe and effective in treatment of patients with decompensated cirrhosis using autologous bone marrow stem cells and umbilical cord blood stem cells transplantation through hepatic artery and no significant difference was observed between the two group.