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背景:骨髓间充质干细胞在特定环境下可分化成肝干细胞及肝细胞,从而参与肝结构和功能的修复和重构。目的:进一步验证自体骨髓间充质干细胞培养后经肝动脉介入治疗肝硬化的安全性、可行性及疗效。方法:1例肝硬化患者进行自体骨髓单个核细胞移植,骨穿采集自体骨髓体外分离纯化骨髓单个核细胞。骨髓单核细胞培养4d后经肝动脉插管将其移植入肝脏。移植后4周观察血清白蛋白、胆碱酯酶、凝血酶原活动度、总胆红素、谷丙转氨酶、谷草转氨酶、凝血酶原时间、纤维蛋白原变化情况,观察患者并发症及预后。结果与结论:培养后骨髓间充质干细胞数量明显增多,患者移植前后各项指标变化情况:移植前血清白蛋白、胆碱酯酶、凝血酶原活动度、谷丙转氨酶、谷草转氨酶、凝血酶原时间、纤维蛋白原分别为29.43g/L,2378.5U/L,47.4%,112.78U/L,79.36U/L,17.91s,2.01g/L。移植后4周分别为33.30g/L,2866.5U/L,55.8%,79.01U/L,56.37U/L,16.26s,2.35g/L。移植后无严重不良事件发生。结果表明,自体骨髓间充质干细胞移培养后植治疗可使失代偿期肝硬化患者肝功能明显改善,治疗安全有效且不良反应小,可作为中晚期肝硬化患者的临床治疗方案。
BACKGROUND: Bone marrow-derived mesenchymal stem cells can differentiate into hepatic stem cells and hepatocytes in specific environment, and thus participate in the repair and remodeling of liver structure and function. Objective: To further verify the safety, feasibility and efficacy of autologous bone marrow mesenchymal stem cells cultured with hepatic artery interventional therapy for cirrhosis. Methods: One patient with liver cirrhosis underwent autologous bone marrow mononuclear cell transplantation. Bone marrow mononuclear cells were isolated and purified from bone marrow in vitro. Bone marrow mononuclear cells were transplanted to the liver via hepatic artery after 4 days of culture. Four weeks after transplantation, serum albumin, cholinesterase, prothrombin activity, total bilirubin, alanine aminotransferase, aspartate aminotransferase, prothrombin time and fibrinogen were observed to observe the complication and prognosis of patients. RESULTS AND CONCLUSION: The number of bone marrow mesenchymal stem cells significantly increased after transplantation. The changes of indexes before and after transplantation: serum albumin, cholinesterase, prothrombin activity, alanine aminotransferase, aspartate aminotransferase, thrombin The original time, fibrinogen 29.43g / L, 2378.5U / L, 47.4%, 112.78U / L, 79.36U / L, 17.91s, 2.01g / L. Four weeks after transplantation, they were 33.30g / L, 2866.5U / L, 55.8%, 79.01U / L, 56.37U / L, 16.26s, 2.35g / L, respectively. No severe adverse events occurred after transplantation. The results showed that transplantation of autologous bone marrow mesenchymal stem cells after transplantation could significantly improve the liver function of patients with decompensated cirrhosis, which was safe and effective with little adverse reactions and could be used as a clinical treatment for patients with advanced liver cirrhosis.