CAJ | 학술논문

目的：评价自体外周血干细胞移植治疗失代偿期肝硬化的效果。方法选择42例住院治疗的失代偿期肝硬化患者，分为干细胞移植组20例和对照组22例，两组均予以相同的内科综合治疗，干细胞移植组加行经肝动脉自体外周血干细胞移植术，观察患者术后乏力、纳差、腹胀等主要症状的变化，检测移植术后4、8、12、24周肝功能、凝血功能等指标的变化，同期检测对照组的变化。结果两组患者在治疗后观察期间的主要症状乏力、纳差、腹胀均有改善。20例干细胞移植组患者手术均成功，无特殊不良反应及并发症。术后8、12、24周干细胞移植组患者肝功白蛋白均较术前明显回升（P ＜0.05），与对照组比较差异有统计学意义（P ＜0.05）。术后12周、24周细胞移植组凝血酶原活动度以及术后24周细胞移植组凝血酶原时间较术前明显改善（P ＜0.05），但组间比较无统计学差异。术后12周、24周 Child 评分较术前及对照组明显改善，差异有统计学意义（P ＜0.01）。结论经肝动脉自体外周血干细胞移植治疗失代偿期肝硬化是一种安全、有效的微创治疗方法，可在一定程度上改善患者的低蛋白血症及凝血功能。
목적：평개자체외주혈간세포이식치료실대상기간경화적효과。방법선택42례주원치료적실대상기간경화환자，분위간세포이식조20례화대조조22례，량조균여이상동적내과종합치료，간세포이식조가행경간동맥자체외주혈간세포이식술，관찰환자술후핍력、납차、복창등주요증상적변화，검측이식술후4、8、12、24주간공능、응혈공능등지표적변화，동기검측대조조적변화。결과량조환자재치료후관찰기간적주요증상핍력、납차、복창균유개선。20례간세포이식조환자수술균성공，무특수불량반응급병발증。술후8、12、24주간세포이식조환자간공백단백균교술전명현회승（P ＜0.05），여대조조비교차이유통계학의의（P ＜0.05）。술후12주、24주세포이식조응혈매원활동도이급술후24주세포이식조응혈매원시간교술전명현개선（P ＜0.05），단조간비교무통계학차이。술후12주、24주 Child 평분교술전급대조조명현개선，차이유통계학의의（P ＜0.01）。결론경간동맥자체외주혈간세포이식치료실대상기간경화시일충안전、유효적미창치료방법，가재일정정도상개선환자적저단백혈증급응혈공능。
Objective To evaluate efficacy of autologous peripheral stem cell transplantation in treatment of decompensated hepatic cirrhosis.Methods Forty-two patients with decompensated hepatic cirrhosis were enrolled,and divided into stem cell transplantation group (n = 20 )and control group (n = 22 ).Both groups received the same comprehensive treatment,while cell transplantation group additionally underwent autologous peripheral blood stem cell transplantation.Clinical manifestations including hypodynamia,anorexia and abdominal distension were observed after treatment.At week 4,8,12,24 after therapy,liver function and coagulation function were tested.Results Most patients had improvement in symptoms such as hypodynamia, anorexia, abdominal distension after treatment. Successful transplantations were achieved in all the 20 patients without obvious complications.Albumin (ALB)increased obviously (P<0.05)at week 8 ,12 and 24 after transplantation,of which improvement was better in transplantation group than that in control group.Coagulation function improved since week 12 after transplantation,while there were no significant differences between the two groups.Child-Pugh class of transplantation group improved obviously than that of control group since week12 (P <0.01).Conclusion Transplantation of autologous peripheral stem cells via hepatic artery is safe and effective in treatment of patients with decompensated cirrhosis,for which it could improve hypoproteinemia and coagulation function.