CAJ | 학술논문

目的观察脐带间充质干细胞治疗慢加急性肝衰竭患者近期疗效与安全性.方法取健康孕妇正常分娩婴儿的脐带,分离、培养获得脐带间充质干细胞(UC- MSCs),采用荧光标记的鼠抗人PE-CD29、FITC-CD34、PE-CD44和FITC-CD45抗体标记,在流式细胞仪上检测细胞表面抗原进行鉴定.在35例慢加急性肝衰竭患者中,8例(A组)患者经前臂静脉进行UC-MSCs移植,8例(B组)患者经股动脉插管行肝动脉移植,两组移植的UC-MSC数量为>5×107.另19例(C组)患者仅接受内科综合支持治疗.观察患者血生化指标、终末期肝病模型(MELD)评分及临床症状和不良反应的发生情况.结果在治疗12周时,C组患者死亡7例(36.8%),而A组死亡1例(12.5%),B组死亡2例(25.0%),细胞移植患者病死率明显低于C组(P<0.05);A组患者TBIL、Cr、ALB、INR和MELD 分别为36.8±12.4μmol/L、70.6±18.6μmol/L、34.5±5.6g/L、1.2±0.2和18.6±3.2,B 组分别为50.2±15.4μmol/L、66.5±20.0μmol/L、35.5±3.4g/L、1.1±0.2和18.7±3.4,而C组则分别为43.9±17.2μmol/L、89.4±25.6μmol/L、29.5±5.3g/L、1.6±0.3和22.7±3.9,前两组各项指标改善明显优于C组(P<0.05);16例进行细胞移植的患者术中未出现严重的不良反应,未发生与移植相关的严重并发症.结论人脐带间充质干细胞治疗慢加急性肝衰竭患者可明显提高患者近期生存率,并具有良好的安全性.
목적관찰제대간충질간세포치료만가급성간쇠갈환자근기료효여안전성.방법취건강잉부정상분면영인적제대,분리、배양획득제대간충질간세포(UC- MSCs),채용형광표기적서항인PE-CD29、FITC-CD34、PE-CD44화FITC-CD45항체표기,재류식세포의상검측세포표면항원진행감정.재35례만가급성간쇠갈환자중,8례(A조)환자경전비정맥진행UC-MSCs이식,8례(B조)환자경고동맥삽관행간동맥이식,량조이식적UC-MSC수량위>5×107.령19례(C조)환자부접수내과종합지지치료.관찰환자혈생화지표、종말기간병모형(MELD)평분급림상증상화불량반응적발생정황.결과재치료12주시,C조환자사망7례(36.8%),이A조사망1례(12.5%),B조사망2례(25.0%),세포이식환자병사솔명현저우C조(P<0.05);A조환자TBIL、Cr、ALB、INR화MELD 분별위36.8±12.4μmol/L、70.6±18.6μmol/L、34.5±5.6g/L、1.2±0.2화18.6±3.2,B 조분별위50.2±15.4μmol/L、66.5±20.0μmol/L、35.5±3.4g/L、1.1±0.2화18.7±3.4,이C조칙분별위43.9±17.2μmol/L、89.4±25.6μmol/L、29.5±5.3g/L、1.6±0.3화22.7±3.9,전량조각항지표개선명현우우C조(P<0.05);16례진행세포이식적환자술중미출현엄중적불량반응,미발생여이식상관적엄중병발증.결론인제대간충질간세포치료만가급성간쇠갈환자가명현제고환자근기생존솔,병구유량호적안전성.
Objective To investigate the efficacy of human umbilical cord-derived mesenchymal stem cells (UC-MSCs) in treatment of patients with subacute-on-chronic liver failure. Methods 35 patients with suba-cute-on-chronic liver failure were recruited in this study. 19 patients in group C were treated with conventional therapy,while 8 patients in group A were treated with UC-MSC transplantation via peripheral vein and other 8 patients had cell transplantation via hepatic artery by Seldingers. Results At the end of three month observa-tion after cell transplantation,seven patients(36.8%) in group C died,while only one (12.5%)in group A and two (25.0%)in group B died respectively (P<O.05);the total serum bilirubin,creatinine,albumin,international ratio of prothrombin time and model of end stage liver disease in group A were 36.8±12.4μmol/L,70.6±18.6μmol/L,34.5± 5.6g/L,1.2±0.2 and 18.6±3.2,in group B were 50.2±15.4μmol/L,66.5±20.0μmol/L,35.5±3.4g/L,1.1±0.2 and 18.7± 3.4,while in group C,they were 43.9±17.2μmol/L,89.4±25.6μmol/L,29.5±5.3g/L,1.6±0.3 and 22.7±3.9,respectively. The improvement in the former two groups was superior to that in group C (P<0.05);No severe side effects were found in 16 patients with stem cell transplantation. Conclusion The transplantation of UC-MSCs is effective in the treatment of patients with subacute-on-chronic liver failure.