中华消化病与影像杂志（电子版）
中華消化病與影像雜誌（電子版）
중화소화병여영상잡지（전자판）
2015年
3期
11-15
,共5页
干细胞移植%肝硬化%恩替卡韦
榦細胞移植%肝硬化%恩替卡韋
간세포이식%간경화%은체잡위
Stem cell transplantation%Liver cirrhosis%Entecavir
目的：观察自体骨髓干细胞移植联合恩替卡韦治疗乙型肝炎肝硬化失代偿期的临床疗效。方法选取河南省商丘市第一人民医院40例初诊的乙型肝炎肝硬化失代偿期患者，随机分为2组：对照组22例予以常规保肝治疗及恩替卡韦抗病毒治疗。治疗组18例在对照组治疗的基础上，行经肝动脉途径自体骨髓干细胞移植治疗。观察两组患者2、4、8、12周的临床症状体征，谷丙转氨酶、血清白蛋白、总胆红素、凝血酶原活动度、肝纤维化四项、HBV-DNA等指标变化，比较两组患者第12周的临床症状体征及化验室指标。结果经治疗后两组患者纳差、乏力、腹胀、腹水及双下肢水肿等临床症状体征均有不同程度的改善，以治疗组明显。术后第12周两组HBV-DNA检测均低于最低检出值。经治疗后两组谷丙转氨酶、总胆红素及肝纤维化四项等指标均有不同程度下降，血清白蛋白、凝血酶原活动度等均有所改善，以治疗组明显。两组患者Child-Pugh评分及终末期肝病模型评分均较治疗前有所下降，以治疗组明显。结论自体干细胞移植联合恩替卡韦治疗失代偿期乙型肝炎肝硬化患者，能够明显改善患者的临床症状及肝脏功能。自体骨髓干细胞移植是治疗乙型肝炎肝硬化失代偿期的新的有效手段。
目的：觀察自體骨髓榦細胞移植聯閤恩替卡韋治療乙型肝炎肝硬化失代償期的臨床療效。方法選取河南省商丘市第一人民醫院40例初診的乙型肝炎肝硬化失代償期患者，隨機分為2組：對照組22例予以常規保肝治療及恩替卡韋抗病毒治療。治療組18例在對照組治療的基礎上，行經肝動脈途徑自體骨髓榦細胞移植治療。觀察兩組患者2、4、8、12週的臨床癥狀體徵，穀丙轉氨酶、血清白蛋白、總膽紅素、凝血酶原活動度、肝纖維化四項、HBV-DNA等指標變化，比較兩組患者第12週的臨床癥狀體徵及化驗室指標。結果經治療後兩組患者納差、乏力、腹脹、腹水及雙下肢水腫等臨床癥狀體徵均有不同程度的改善，以治療組明顯。術後第12週兩組HBV-DNA檢測均低于最低檢齣值。經治療後兩組穀丙轉氨酶、總膽紅素及肝纖維化四項等指標均有不同程度下降，血清白蛋白、凝血酶原活動度等均有所改善，以治療組明顯。兩組患者Child-Pugh評分及終末期肝病模型評分均較治療前有所下降，以治療組明顯。結論自體榦細胞移植聯閤恩替卡韋治療失代償期乙型肝炎肝硬化患者，能夠明顯改善患者的臨床癥狀及肝髒功能。自體骨髓榦細胞移植是治療乙型肝炎肝硬化失代償期的新的有效手段。
목적：관찰자체골수간세포이식연합은체잡위치료을형간염간경화실대상기적림상료효。방법선취하남성상구시제일인민의원40례초진적을형간염간경화실대상기환자，수궤분위2조：대조조22례여이상규보간치료급은체잡위항병독치료。치료조18례재대조조치료적기출상，행경간동맥도경자체골수간세포이식치료。관찰량조환자2、4、8、12주적림상증상체정，곡병전안매、혈청백단백、총담홍소、응혈매원활동도、간섬유화사항、HBV-DNA등지표변화，비교량조환자제12주적림상증상체정급화험실지표。결과경치료후량조환자납차、핍력、복창、복수급쌍하지수종등림상증상체정균유불동정도적개선，이치료조명현。술후제12주량조HBV-DNA검측균저우최저검출치。경치료후량조곡병전안매、총담홍소급간섬유화사항등지표균유불동정도하강，혈청백단백、응혈매원활동도등균유소개선，이치료조명현。량조환자Child-Pugh평분급종말기간병모형평분균교치료전유소하강，이치료조명현。결론자체간세포이식연합은체잡위치료실대상기을형간염간경화환자，능구명현개선환자적림상증상급간장공능。자체골수간세포이식시치료을형간염간경화실대상기적신적유효수단。
Objective To observe the clinical efficacy of transplantation of autologous bone marrow stem cells combined with entecavir treating hepatitis B patients with decompensated cirrhosis.Methods Forty newly diagnosed hepatitis B patients with decompensated cirrhosis in the First People′s Hospital of Shangqiu of Henan Province were randomly divided into control group and observation group.The 22 patients in control group were treated with conventional liver protected treatment and entecavir antiviral therapy.On the basis of the control group,the 18 patients in observation group were treated with transplantation of autologous bone marrow stem cells through hepatic artery.The clinical symptoms and signs of the two groups were observed and the changes of alanine transaminase,serum albumin,total bilirubin,prothrombin activity,four items of hepatic fibrosis and HBV-DNA were tested in 2,4,8,12 weeks.All test results were compared in 12 weeks. Results After treatment,the clinical symptoms such as anorexia,feeble,bloating,ascites and legs edema of the two groups were improved in different degrees,but the observation group improved significantly.The HBV-DNA values of the two groups at 12 weeks after operation were lower than the minimum detection value.After treatment,the alanine transaminase, total bilirubin and four items of hepatic fibrosis of the two groups decreased in different degrees,and serum albumin and prothrombin activity improved in different degrees,but the observation group improved significantly.The Child-Pugh score and model for end-stage liver disease score of the two groups declined, but the observation group improved significantly.Conclusions Transplantation of autologous bone marrow stem cells combined with entecavir can improve the clinical symptoms and liver function of hepatitis B patients with decompensated cirrhosis.Transplantation of autologous bone marrow stem cells is a new effective method to treat hepatitis B patients with decompensated cirrhosis.
