脐带血移植治疗重型病毒性肝炎疗效的临床与实验研究

Clinical and experimental study on therapeutic effect of umbilical cord blood transplantation on severe viral hepatitis.

作者信息

Tang Xiao-Peng, Yang Xu, Tan Hui, Ding Yi-Ling, Zhang Min, Wang Wen-Long

机构信息

Research Center of Liver Diseases, the Second Xiangya Hospital, Zhongnan University, Changsha 410011, Hunan Province, China.

出版信息

World J Gastroenterol. 2003 Sep;9(9):1999-2003. doi: 10.3748/wjg.v9.i9.1999.

DOI:10.3748/wjg.v9.i9.1999

PMID:12970893

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4656661/

Abstract

AIM

To investigate the therapeutic effect of umbilical cord blood transplantation (UCBT) on patients with severe viral hepatitis and on liver lesions in rats.

METHODS

One hundred and fifty three patients with severe viral hepatitis were included in the study between April 1990 and July 2002. The patients were treated with adult plasma transfusion (control), UCBT, plasma exchange (PE) and UCBT combined with PE (UCBT+PE) respectively. The therapeutic effectiveness was evaluated by serial determinations of liver function, lipids and immune function in all patients before and after the treatment. The model of experimental hepatic failure was constructed in SD rats by injecting carbon tetrachloride. Then, the rats were given normal saline, adult plasma or neonate cord blood intraperitoneally. After detection of liver function, the rats were killed and morphological changes of the liver were microscopically observed.

RESULTS

UCBT group and UCBT+PE group had much better improvement in liver and immune functions than control group and PE group. The patients in UCBT+PE group had the best clinical efficacy. UCBT was safe and had no side effects. The animal experiment showed significant improvements in liver function and survival rate in neonate cord blood group as compared with adult plasma group. The histopathology of rat's liver indicated that neonate cord blood application could decrease the liver injury and increase hepatocellular regeneration.

CONCLUSION

UCBT demonstrated a good therapeutic effect on severe viral hepatitis and no obvious side effects. Umbilical cord blood can attenuate the liver lesions and reproduce hepatocyte. The treatment of UCBT combined with PE was much better than that of single plasma exchange, thus UCBT can enhance the therapeutic effect of plasma exchange on severe viral hepatitis.

摘要

目的

探讨脐带血移植（UCBT）对重型病毒性肝炎患者及大鼠肝脏病变的治疗作用。

方法

1990年4月至2002年7月，153例重型病毒性肝炎患者纳入本研究。患者分别接受成人血浆输注（对照组）、脐带血移植、血浆置换（PE）以及脐带血移植联合血浆置换（UCBT + PE）治疗。通过在治疗前后对所有患者的肝功能、血脂和免疫功能进行系列测定来评估治疗效果。通过注射四氯化碳在SD大鼠中构建实验性肝衰竭模型。然后，给大鼠腹腔注射生理盐水、成人血浆或新生儿脐带血。检测肝功能后，处死大鼠并显微镜下观察肝脏的形态学变化。

结果

脐带血移植组和脐带血移植联合血浆置换组在肝脏和免疫功能方面的改善明显优于对照组和血浆置换组。脐带血移植联合血浆置换组患者的临床疗效最佳。脐带血移植安全且无副作用。动物实验表明，与成人血浆组相比，新生儿脐带血组的肝功能和存活率有显著改善。大鼠肝脏的组织病理学表明，应用新生儿脐带血可减轻肝损伤并促进肝细胞再生。