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目的探讨人肝细胞体内移植治疗药物性重型肝炎患者的有效性与安全性。方法分离健康志愿者捐献的肝脏,获得人原代肝细胞并冷冻保存,复苏后经股动脉插管移植到脾脏,观察治疗前后患者临床症状、血液生化指标及脾脏核磁共振信号的改变。结果人肝脏可获取2×1010肝细胞,复苏后肝细胞活率在70%以上,移植的肝细胞数为2×109个。移植后1个月,患者临床症状明显改善,血BIL、NH3、ALT、AST明显降低,PA水平明显升高。出院50天后随访各项血生化指标均恢复正常,脾脏内可见肝细胞信号。结论肝细胞体内移植是一项安全有效的治疗方法,移植的肝细胞能够在脾脏内增殖、分化,替代或部分恢复肝脏合成、解毒和代谢功能;将为终末期肝病治疗开辟一项新的治疗途径。
Objective To investigate the efficacy and safety of human hepatocyte transplantation in patients with drug-induced severe hepatitis. Methods The liver donated by healthy volunteers was isolated, primary human hepatocytes were obtained and cryopreserved. After resuscitation, the mice were transplanted to the spleen via femoral artery cannulation. Changes of clinical symptoms, blood biochemical parameters and splenic nuclear magnetic resonance signals were observed before and after treatment. Results 2 × 1010 hepatocytes were obtained in human liver, and the viability of hepatocytes recovered after resuscitation was over 70%. The number of transplanted hepatocytes was 2 × 109. One month after transplantation, the clinical symptoms of the patients were significantly improved. The levels of BIL, NH3, ALT and AST were significantly decreased and the levels of PA were significantly increased. After 50 days of discharge, all the blood biochemical indexes returned to normal, and the signals of hepatocytes were observed in the spleen. Conclusion Transplantation of hepatocytes in vivo is a safe and effective treatment. The transplanted hepatocytes can proliferate, differentiate, replace or partially restore the synthesis, detoxification and metabolism of the liver in the spleen. It will open up a new treatment for end-stage liver disease way.