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自体骨髓细胞输注治疗后肝硬化患者肝功能改善

Improved liver function in patients with liver cirrhosis after autologous bone marrow cell infusion therapy.

作者信息

Terai Shuji, Ishikawa Tsuyoshi, Omori Kaoru, Aoyama Koji, Marumoto Yoshio, Urata Yohei, Yokoyama Yuichirou, Uchida Koichi, Yamasaki Takahiro, Fujii Yasuhiko, Okita Kiwamu, Sakaida Isao

机构信息

Department of Molecular Science & Applied Medicine (Gastroenterology & Hepatology), Yamaguchi University Graduate School of Medicine, Minami Kogushi 1-1-1, Ube, Yamaguchi 755-8505, Japan.

出版信息

Stem Cells. 2006 Oct;24(10):2292-8. doi: 10.1634/stemcells.2005-0542. Epub 2006 Jun 15.

Abstract

We here report nine liver cirrhosis (LC) patients that underwent autologous bone marrow cell infusion (ABMI) from the peripheral vein. Subjects were patients with LC with total bilirubin of less than 3.0 mg/dl, platelet count of more than 5 (10(10)/l), and no viable hepatocellular carcinoma on diagnostic imaging. Autologous bone marrow (BM; 400 ml) was isolated from the ilium under general anesthesia. Mononuclear cells (MNCs) were separated by cell washing and were infused via the peripheral vein. MNC characteristics were confirmed by fluorescence-activated cell sorting analysis (CD34, CD45, and c-kit). After ABMI therapy, liver function was monitored by blood examination for 24 weeks. From 400 ml of BM, we obtained 7.81 +/- 0.98 x 10(9) MNCs. After washing, 5.20 +/- 0.63 x 10(9) MNCs were infused into patients with LC. Significant improvements in serum albumin levels and total protein were observed at 24 weeks after ABMI therapy (p < .05). Significantly improved Child-Pugh scores were seen at 4 and 24 weeks (p < .05). alpha-Fetoprotein and proliferating cell nuclear antigen (PCNA) expression in liver biopsy tissue was significantly elevated after ABMI therapy (p < .05). No major adverse effects were noted. In conclusion, ABMI therapy should be considered as a novel treatment for patients with decompensated LC.

摘要

我们在此报告9例接受外周静脉自体骨髓细胞输注(ABMI)的肝硬化(LC)患者。研究对象为总胆红素低于3.0mg/dl、血小板计数高于5×10¹⁰/l且诊断性影像学检查未发现存活肝细胞癌的LC患者。在全身麻醉下从髂骨分离出自体骨髓(BM;400ml)。通过细胞洗涤分离单核细胞(MNCs),并经外周静脉输注。通过荧光激活细胞分选分析(CD34、CD45和c-kit)确认MNCs特征。ABMI治疗后,通过血液检查监测肝功能24周。从400ml BM中,我们获得了7.81±0.98×10⁹个MNCs。洗涤后,将5.20±0.63×10⁹个MNCs输注到LC患者体内。ABMI治疗24周后,血清白蛋白水平和总蛋白显著改善(p<0.05)。在4周和24周时观察到Child-Pugh评分显著改善(p<0.05)。ABMI治疗后,肝活检组织中的甲胎蛋白和增殖细胞核抗原(PCNA)表达显著升高(p<0.05)。未观察到重大不良反应。总之,ABMI治疗应被视为失代偿性LC患者的一种新的治疗方法。

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