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目的:探讨人脐血干细胞(umbilical cord blood stem cell,UCBSC)外周静脉移植治疗失代偿期肝硬化的临床疗效及可行性。方法:20例失代偿期肝硬化患者采用人UCBSC外周静脉移植治疗,治疗后定期观察患者血清转氨酶(ALT、AST)、总胆红素(TBIL)、白蛋白(ALB)、凝血酶原时间(PT)和纤维蛋白原(FIB)水平变化,并观察患者临床症状及体征的改善情况及不良反应。结果:UCBSC移植治疗后2周,各项肝功能指标较治疗前无显著性差异(P>0.05);治疗后4周,除ALT和AST有所改善外(P<0.05),其余指标无明显改善;治疗后8周各项肝功能指标均有改善(P<0.05),12周有显著性改善(P<0.01)。治疗后4周大多数患者的临床症状有明显改善,腹水减少和双下肢浮肿减轻15例(75.0%)、乏力好转16例(80%)、食欲改善13例(65%)。UCBSC移植后12周患者总体生存率为90%,其中2例患者分别在UCBSC静脉移植后4周和8周因为肝性昏迷和自发性细菌性腹膜炎而死亡。所有患者均未发现与细胞移植相关的副作用。结论:UCBSC外周静脉移植是治疗失代偿期肝硬化一种安全有效的方法,短期内可以改善失代偿期肝硬化患者肝功能及临床症状,是一种值得推荐的治疗方法。
Objective: To investigate the clinical efficacy and feasibility of umbilical cord blood stem cell (UCBSC) peripheral vein grafting in the treatment of decompensated cirrhosis. Methods: Twenty patients with decompensated cirrhosis were treated with peripheral vein grafts of human UCBSC. The levels of serum ALT, AST, TBIL, ALB and prothrombin time (PT) and fibrinogen (FIB), and to observe the clinical symptoms and signs of patients with improvement and adverse reactions. Results: After 2 weeks of UCBSC transplantation, there was no significant difference in the indexes of liver function between the two groups (P> 0.05). After 4 weeks of treatment, except ALT and AST improved (P <0.05) (P <0.05), and improved significantly after 12 weeks of treatment (P <0.01). Four weeks after treatment, the clinical symptoms of most patients were significantly improved. Ascites reduction and edema of both lower extremities were alleviated in 15 (75.0%), fatigue in 16 (80%) and appetite improvement in 13 (65%) patients. The overall survival rate was 90% at 12 weeks after UCBSC transplantation, with 2 of 2 patients dying from hepatic coma and spontaneous bacterial peritonitis 4 and 8 weeks after UCBSC vein graft, respectively. No side effects associated with cell transplantation were found in all patients. Conclusion: UCBSC peripheral vein grafting is a safe and effective method for the treatment of decompensated cirrhosis. It can improve the liver function and clinical symptoms in patients with decompensated cirrhosis in short term. It is a recommended treatment.