肝动脉灌注干细胞治疗失代偿期肝硬化患者的临床研究

摘要

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,IgG、IgA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 arterial infusion of stem cells in treatment of patients with de-compensated cirrhosis. Methods:The cord blood 100-120mL of the healthy pregnant women giving birth in our hospital was collected. In strict accordance with the kit instructions, umbilical cord blood stem cell suspension 10mL was isolated. Modified Seldinger tech-nique using percutaneous femoral artery catheterization was used to place the tube in the common hepatic artery for angiography, space-occupied lesions were excluded and intrahepatic vascular conditions were observed. Further in-depth catheter in the hepatic artery, the prepared stem cell suspension 10mL was slowly injected into within 20-30min. After the treatment, all patients were monitored with persistent ECG 12h, and given conventional drugs to hepatoprotection, anti-virus, albumin infusion and other symptomatic treat-ment. Results:After the treatment, the patient's liver function was improved significantly, ALT, AST, TBIL, G levels were decreased significantly compared with those before the treatment, A and PT levels were increased compared with those before the treatment, and the differences were statistically significant. The immune parameters showed that CD3, CD8, CD25, IgG, and IgA were increased compared with those before the treatment, and the differences were statistically significant. The liver imaging displayed that maximum cross-sectional area of the liver and liver unenhanced CT values were improved compared with those before the treatment, and the differences were statistically significant (P<0. 05). All patients had no serious adverse reactions. Conclusions:Hepatic arterial infu-sion of stem cells in the treatment of decompensated cirrhosis can improve liver function in the patients, restore immune damages, and improve the patient's liver morphology, and has small adverse reactions.