CAJ | 학술논문

目的探索克服供体肝脏短缺的新途径,观察自体外周血CD34+干细胞移植治疗100例晚期肝硬化的临床疗效.方法对内科严格保守治疗无效的100例晚期肝硬化患者,采用自体外周血CD34+干细胞移植,分别在术后6个月、12个月观察肝生物合成功能(凝血功能、白蛋白水平、吲哚青绿试验、Child Pugh评分)、肝脏的组织病理学改变(Knodell评分)、以及肝脏形态学改变.组间比较及组内比较均先进行方差齐性检验,当方差分析有意义时,采用Bonferroni检验行组内两两比较.结果 100例患者术后1年生存率100％,其中52例大量腹水患者术后腹水逐渐减少直到消失.4例术后3个月出现上消化道出血,3例出现Ⅰ～Ⅱ度肝性脑病.移植术后肝脏合成功能、肝脏储备功能、肝弹性测定及肝总组织检查(Knodell评分)均有显著改善,与移植前相比差异有统计学意义(P＜0.05).结论自体外周血CD34+干细胞移植是安全、有效和性价比高的方法;CD34+干细胞能有效地改善晚期肝硬化患者的肝脏功能、肝组织形态学以及提高患者的生活质量.
목적 탐색극복공체간장단결적신도경,관찰자체외주혈CD34+간세포이식치료100례만기간경화적림상료효.방법 대내과엄격보수치료무효적100례만기간경화환자,채용자체외주혈CD34+간세포이식,분별재술후6개월、12개월관찰간생물합성공능(응혈공능、백단백수평、신타청록시험、Child Pugh평분)、간장적조직병이학개변(Knodell평분)、이급간장형태학개변.조간비교급조내비교균선진행방차제성검험,당방차분석유의의시,채용Bonferroni검험행조내량량비교.결과 100례환자술후1년생존솔100％,기중52례대량복수환자술후복수축점감소직도소실.4례술후3개월출현상소화도출혈,3례출현Ⅰ～Ⅱ도간성뇌병.이식술후간장합성공능、간장저비공능、간탄성측정급간총조직검사(Knodell평분)균유현저개선,여이식전상비차이유통계학의의(P＜0.05).결론 자체외주혈CD34+간세포이식시안전、유효화성개비고적방법;CD34+간세포능유효지개선만기간경화환자적간장공능、간조직형태학이급제고환자적생활질량.
Objective To investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors.Methods A total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up.Results The 1-year cumulative survival rate was 100％.Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (Ⅰ-Ⅱ degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P＜ 0.05).Conclusion Autologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.