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失代偿期肝硬化患者自体骨髓间充质干细胞移植的1期试验

Phase 1 trial of autologous bone marrow mesenchymal stem cell transplantation in patients with decompensated liver cirrhosis.

作者信息

Mohamadnejad Mehdi, Alimoghaddam Kamran, Mohyeddin-Bonab Mandana, Bagheri Mohamad, Bashtar Maryam, Ghanaati Hossein, Baharvand Hossein, Ghavamzadeh Ardeshir, Malekzadeh Reza

机构信息

Digestive Disease Research Center, Medical Sciences/ Tehran University, Tehran, Iran.

出版信息

Arch Iran Med. 2007 Oct;10(4):459-66.

Abstract

BACKGROUND

The standard treatment for decompensated liver cirrhosis is liver transplantation. However, it has several limitations. Recent animal studies suggest that bone marrow stem cell transplantation can lead to regression of liver fibrosis. The objective of this study was to determine the safety and feasibility of autologous bone marrow-mesenchymal stem cell transplantation in patients with decompensated liver cirrhosis.

METHODS

In this phase 1 trial, four patients with decompensated liver cirrhosis were included. Their bone marrow was aspirated, mesenchymal stem cells were cultured, and a mean 31.73 x 10(6) mesenchymal stem cells were infused through a peripheral vein. Primary outcomes were evaluating the safety and feasibility of the work. Secondary outcomes were evaluating changes in the model for end-stage liver disease score, and the quality of life of the patients.

RESULTS

There were no side-effects in the patients during follow-up. The model for end-stage liver disease scores of patients 1, and 4 improved by four and three points, respectively by the end of follow-up. Furthermore, the quality of life of all four patients improved by the end of follow-up. Using SF-36 questionnaire, the mean physical component scale increased from 31.44 to 65.19, and the mean mental component scale increased from 36.32 to 65.55.

CONCLUSION

Mesenchymal stem cell transplantation seems to be feasible and safe in the treatment of decompensated liver cirrhosis.

摘要

背景

失代偿期肝硬化的标准治疗方法是肝移植。然而,它存在一些局限性。最近的动物研究表明,骨髓干细胞移植可导致肝纤维化消退。本研究的目的是确定自体骨髓间充质干细胞移植在失代偿期肝硬化患者中的安全性和可行性。

方法

在这项1期试验中,纳入了4例失代偿期肝硬化患者。抽取他们的骨髓,培养间充质干细胞,并通过外周静脉输注平均31.73×10⁶个间充质干细胞。主要结局是评估该操作的安全性和可行性。次要结局是评估终末期肝病模型评分的变化以及患者的生活质量。

结果

随访期间患者无副作用。随访结束时,患者1和患者4的终末期肝病模型评分分别提高了4分和3分。此外,所有4例患者的生活质量在随访结束时均有所改善。使用SF-36问卷,平均身体成分量表从31.44增加到65.19,平均心理成分量表从36.32增加到65.55。

结论

间充质干细胞移植在失代偿期肝硬化的治疗中似乎是可行且安全的。

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