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[目的]探讨负筛选混合法分离提纯脐血干细胞治疗失代偿期肝硬化的疗效和安全性。[方法]62例Child C级的肝硬化失代偿期患者为治疗组,无菌采脐血,用负筛选混合法分离纯化脐血干细胞,流式鉴定干细胞数1×107个/ml以上,活性95%以上,在数字减影血管造影(DSA)下经肝动脉灌注治疗。术后4周、12周、24周、1年、2年、3年定期随访,观察患者症状、体征、不良反应及相关实验室指标。同时选取同期行常规治疗的失代偿肝硬化患者作为对照组。[结果]治疗组术后12周乏力、纳差、腹胀等症状明显缓解,顽固性腹水有效控制;血清白蛋白(ALB)提高最早而明显,4周后开始呈持续升高趋势,总胆红素(TB)在治疗后逐步下降,至第12周时下降更为明显,与治疗前比较差异有统计学意义(P<0.05);3年随访,58例患者治疗后恢复至Child B级及以上。治疗组所有病例未发生与干细胞治疗相关的并发症及不良反应,疗效优于对照组(P<0.05)。[结论]负筛选混合法分离提纯脐血干细胞治疗失代偿期肝硬化患者安全、有效。
[Objective] To investigate the curative effect and safety of negative screening mixed method for isolation and purification of umbilical cord blood stem cells for the treatment of decompensated cirrhosis. [Method] Sixty-two Child C-type patients with decompensated liver cirrhosis were treated with sterile cord blood. Umbilical cord blood stem cells were isolated and purified by negative screening hybridization. The numbers of stem cells were identified as 1 × 107 cells / ml by flow cytometry. Over 95% activity was transcatheter hepatic arterial infusion under digital subtraction angiography (DSA). The patients were followed up for 4 weeks, 12 weeks, 24 weeks, 1 year, 2 years and 3 years respectively. The symptoms, signs, adverse reactions and related laboratory parameters were observed. At the same time select the routine treatment of patients with decompensated cirrhosis as a control group. [Results] The symptoms of 12 weeks after operation in the treatment group were relieved, symptoms such as anorexia and bloating were obviously relieved, and refractory ascites was effectively controlled. Serum albumin (ALB) increased the earliest and obviously after 4 weeks, The levels of TB decreased gradually after treatment and decreased more significantly at week 12, with statistical significance (P <0.05). After 3 years of follow-up, 58 patients recovered to Child B Class the above. All the cases in the treatment group did not have the complications and adverse reactions related to stem cell therapy, and the curative effect was better than that in the control group (P <0.05). [Conclusion] Separation and purification of umbilical cord blood stem cells by negative screening and mixing method in the treatment of decompensated cirrhosis patients is safe and effective.