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目的:探讨肝动脉灌注干细胞治疗失代偿期肝硬化患者的临床研究。方法:采集健康产妇的脐血100~120 ml,严格按照试剂盒说明书分离脐血干细胞悬液10 ml。使用改良Seldinger技术行经皮穿刺股动脉插管术,将管置入失代偿期肝硬化患者肝总动脉进行造影,排除占位性病变,并观察肝内血管情况。再深入导管于肝固有动脉,将准备好的干细胞悬液10 ml缓慢注入,注入时间20~30 min。治疗后所有患者持续心电监护12 h,常规予以药物保肝、抗病毒、输注白蛋白等对症治疗。结果:经治疗后患者的肝功能指标均有显著改善,谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清总胆红素(TBIL)、球蛋白(G)含量较治疗前明显下降,白蛋白(A)含量和凝血酶原(PT)时间较治疗前均有所升高,差异有统计学意义;免疫指标的观察,CD3、CD8、CD25,Ig G、Ig A均较前显著升高,有显著的统计学差异;患者的肝影像学显示,其肝最大截面积、肝平扫CT值均有所改善,与治疗前相比差异有统计学意义(P<0.05);所有患者未发生严重的不良反应。结论:肝动脉灌注干细胞治疗失代偿期肝硬化可改善患者的肝功能,修复免疫损伤,并能改善肝脏形态,不良反应小。
Objective: To investigate the clinical study of hepatic artery perfusion stem cells in patients with decompensated cirrhosis. Methods: Umbilical cord blood was collected from 100 to 120 ml of healthy maternal, and 10 ml of cord blood stem cell suspension was isolated in strict accordance with kit instructions. Percutaneous puncture of femoral artery was performed with modified Seldinger technique. The tube was placed into the common hepatic artery of patients with decompensated cirrhosis for exclusion of space-occupying lesions and the intrahepatic vessels were observed. Then in-depth catheter in the hepatic artery, the prepared 10 ml of stem cell suspension slowly injected, injection time 20 ~ 30 min. After treatment, all patients continued to monitor ECG for 12 hours, routinely treated with drugs such as liver protection, antivirus and albumin infusion. Results: After treatment, the indexes of liver function of patients were significantly improved. The levels of ALT, AST, TBIL and G decreased significantly compared with those before treatment. The levels of white The contents of protein (A) and prothrombin (PT) were higher than those before treatment, and the difference was statistically significant. The immunological indexes of CD3, CD8, CD25, Ig G and Ig A were significantly higher than those before treatment , There was a significant statistical difference. The liver imaging of the patients showed that the maximum cross-sectional area of the liver and the CT value of the liver plain scan improved, with significant difference compared with that before treatment (P <0.05). All the patients did not A serious adverse reaction occurred. Conclusion: Hepatic arterial infusion of stem cells in the treatment of decompensated cirrhosis can improve liver function, repair immune injury, improve liver morphology and reduce adverse reactions.