| AimLiver cirrhosis(LC)is an advanced stage of various chronic liver diseases.Patients often die from one or more complications such as upper gastrointestinal bleeding,spontaneous bacterial peritonitis,hepatic encephalopathy,liver cancer,and hepatorenal syndrome..Liver cirrhosis still lacks effective treatment methods,and the effect of etiological treatment is limited.It is difficult to prevent further development of cirrhosis,and active prevention and treatment of complications in the later stage.Orthotopic liver transplantation can fundamentally solve the liver decompensation of patients,which is end-stage liver disease.The last treatment,but because of the expensive cost of transplantation treatment,liver source shortage,etc.limit its clinical application.The potential clinical application value of bone marrow cell transplantation therapy has attracted more and more attention.The aim of this study was to investigate the safety and efficacy of autologous bone marrow cells in the treatment of cirrhosis with hepatic artery transplantation,in order to accumulate more clinical experience for this new treatment.MethodUsing a retrospective clinical study method,patients who were diagnosed with LC at the Southern Medical University Zhujiang Hospital from January 2014 to December 2016 were divided into bone marrow cell transplantation groups according to whether they received bone marrow cell transplantation and transplantation based on conventional medical treatment.And non-myeloid cell transplantation groups.71 patients with bone marrow cell transplantation and 174 patients with non-myeloid cell transplantation.The clinical characteristics,laboratory,and auxiliary examination results of the selected patients were included as baseline characteristics,and the patient’s 24-month follow-up data were collected and analyzed.The main efficacy evaluation index was serum ALB.The secondary evaluation indexes were:CHE,PTA,TBIL,depth of ascites,ascites grading,complications and prognosis.The changes of the above indicators were compared between the two groups,and the effects of different Child-Pugh grades were analyzed.Result1.After autologous bone marrow cell transplantation,no obvious adverse reactions occurred.2.The main efficacy index ALB changes:serum ALB began to increase in the bone marrow cell transplantation group after 2 months of follow-up after bone marrow cell transplantation,the highest increase at the 12th month,serum ALB decreased at the 24th month after surgery,However,it is still higher than the preoperative level.The ALB of patients with Child-Pugh grade A and grade B is greater than that of grade C patients.There was no significant change in serum ALB at different follow-up points in the non-myeloid cell transplantation group.There were significant differences in serum ALB and non-myeloid cell transplantation groups at 2,6,12,and 24 months after operation in the bone marrow cell transplantation group(P<0.05).3.Changes in secondary efficacy index:PTA changes:PTA began to increase in the bone marrow cell transplantation group after 6 months of follow-up after bone marrow cell transplantation,the most obvious increase in the 12th month,PTA in the 24th month after surgery Decreased,but still higher than the preoperative level,Child-Pugh A and B patients with PTA increased more than C patients.There were no significant changes in PTA at different follow-up points in the non-myeloid cell transplantation group(P>0.05).There were significant differences in serum PTA between the bone marrow cell transplantation group and the non-myeloid cell transplantation group at 6th,12th,and 24th postoperatively(P<0.05).4.Changes in secondary efficacy index CHE:In the bone marrow cell transplantation group,serum began to increase after 2 months of follow-up of bone marrow cell transplantation,and the highest was observed at the 12th month.Serum CHE was observed at the 24th month after surgery.The decline,but still higher than the preoperative level,Child-Pugh A and B patients with a greater degree of CHE than C patients.There were no significant changes in serum CHE at different follow-up points in the non-myeloid cell transplantation group(P>0.05).There were significant differences in serum CHE between the bone marrow cell transplantation group and the non-myeloid cell transplantation group at 2,6,12,and 24 months after operation(P<0.05).5.Changes in secondary efficacy index TBIL:The TBIL of both groups was lower than the baseline value.The bone marrow cell transplantation group was significantly improved after the 6th,12th,and 24th months after transplantation(P<0.05).There was a statistically significant difference in the decrease of TBIL between the non-transplant group at 2,12,and 24 months after follow-up(P<0.05).There was no significant difference in TBIL between the two groups at 24 months follow-up.6.Secondary efficacy index:Depth of peritoneal effusion:The follow-up of the peritoneal effusion depth of the two groups was significantly lower than the baseline value(P<0.05).The bone marrow cell transplantation group was followed up for the second,sixth,and second stages.The depth of peritoneal effusion at 24 months was statistically different from baseline(P<0.05).The depth of peritoneal effusion at 6,12,and 24 months was significantly different from that of the non-myeloid cell transplantation group(P<0.05).The bone marrow cell transplantation group was significantly more significant than the non-myeloid cell transplantation group at 2,6,12,and 24 months after follow-up(P<0.05).7.Secondary efficacy index:Ascites grading changes:The proportion of patients with a small amount of ascites in the bone marrow cell transplantation group was higher than that of the non-myeloid cell transplantation group at the 2nd,6th,12th,and 24th months of follow-up,and 12th and 24th follow-up.The difference was statistically significant at month(P<0.05).8.Secondary efficacy index complications:For the four common UGH,HE,infection(mainly SBP)and HCC,the complications of the two groups were compared,P=0.828,no statistical difference.There were 26 cases of any complications in the bone marrow cell transplantation group and 68 cases in the non-myeloid cell transplantation group.There was no significant difference between the two groups(P=0.647).Two cases of HCC were found in the transplantation group,the cancer rate was 2.8%,and 3 cases of HCC were found in the non-transplant group.The cancer rate was 1.7%.There was no significant difference between the two groups.9.Prognosis of secondary efficacy index:The total follow-up time of the two groups was 6-24 months,the median follow-up time was 21.4 months,and the mortality rate of the bone marrow cell transplantation group was 5.6%(4/71).The non-myeloid cell transplantation group The mortality rate was 6.8%(12/174).There was no significant difference in overall survival between the two groups at 24 months(x2=0.129,P=0.719).Conclusion1.Autologous bone marrow cell transplantation can significantly improve serum ALB,CHE and PTA levels in patients with cirrhosis.2.Autologous bone marrow cell transplantation can significantly improve the cirrhosis with ascites and improve the quality of life of patients.3.Child-Pugh A and B patients had better liver function improvement after autologous bone marrow cell transplantation than Child-Pugh C patients.4.Autologous bone marrow cells have good safety in patients with liver cirrhosis after transhepatic artery transplantation. |
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