Li Lei, Si Yanhui, Cheng Mingrong, Lang Lin, Li Aijun, Liu Baochi
Department of Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P.R. China.
Henuo Medical Clinic, Shanghai New Hongqiao International Medical Center, Shanghai 201100, P.R. China.
Exp Ther Med. 2022 Aug 22;24(4):633. doi: 10.3892/etm.2022.11570. eCollection 2022 Oct.
The 5-year mortality rates associated with decompensated liver cirrhosis (DLC) can reach 50%, which suggests that this condition poses a serious health risk. In previous studies conducted by our group, autologous bone marrow nucleated cells (ABMNCs) were used to treat HIV-positive patients with DLC through the right omental vein; however, trauma and poor compliance were encountered. In the present study, the percutaneous liver approach to inject ABMNCs under the guidance of B-ultrasound was employed for the treatment of DLC. A total of 108 patients with DLC were retrospectively divided into the routine drug treatment group (control group; 30 cases), the right omental vein infusion of ABMNCs group (observation group 1; 38 cases) and the B-ultrasound-guided liver injection of ABMNCs group (observation group 2; 40 cases). After treatment, the liver synthesis (prothrombin time, albumin and ascites) and secretion functions (total bilirubin) in observation groups 1 and 2 were significantly improved compared with those of the control group (P<0.01) and the bone marrow function was also significantly improved compared with that of the control group (P<0.01). While, the bone marrow function (white blood cell, platelet, and hemoglobin) in observation group 1 was significantly improved compared with that of observation group 2 at the end of treatment (P<0.01). After a 1-year follow-up, the case fatality rate was 2.5% (1/40) in observation group 2, which was significantly lower than the 20% fatality rate (6/30) recorded in the control group (P<0.05). The injection of ABMNCs into the liver under the guidance of B-ultrasound was significantly better than conventional drug therapy in treating DLC. This approach has obvious advantages such as no hospitalization, minimal trauma, rapid recovery and good compliance, all of which make it worthy of application in primary hospitals.
失代偿期肝硬化(DLC)的5年死亡率可达50%,这表明该病症构成严重的健康风险。在我们团队之前进行的研究中,自体骨髓有核细胞(ABMNCs)通过右网膜静脉用于治疗HIV阳性的DLC患者;然而,遇到了创伤和依从性差的问题。在本研究中,采用在B超引导下经皮肝穿刺注入ABMNCs的方法治疗DLC。108例DLC患者被回顾性分为常规药物治疗组(对照组;30例)、右网膜静脉输注ABMNCs组(观察组1;38例)和B超引导下经皮肝穿刺注入ABMNCs组(观察组2;40例)。治疗后,观察组1和观察组2的肝脏合成功能(凝血酶原时间、白蛋白和腹水)及分泌功能(总胆红素)与对照组相比均显著改善(P<0.01),骨髓功能与对照组相比也显著改善(P<0.01)。同时,治疗结束时观察组1的骨髓功能(白细胞、血小板和血红蛋白)与观察组2相比显著改善(P<0.01)。随访1年后,观察组2的病死率为2.5%(1/40),显著低于对照组记录的20%的病死率(6/30)(P<0.05)。在B超引导下经皮肝穿刺注入ABMNCs治疗DLC明显优于传统药物治疗。该方法具有无需住院、创伤极小、恢复快和依从性好等明显优势,所有这些使其值得在基层医院应用。