Abstract:Objective: To study the curative efficacy of autologous bone marrow stem cells in treatment of biliary cirrhosis and effects on serum alpha fetoprotein(AFP), carbohydrate antigen 125(CA125) and liver fibrosis. Methods: 95 patients of biliary cirrhosis who received therapy from January 2016 to January 2018 in our hospital were were divided into the 50 cases of the observation group and the 45 cases of the control group by the simlpe random number table, the control group was given routine treatment, including oral ursodeoxycholic acid capsules, polyene phosphatidylcholine capsules, Compound Glycyrrhizin tablets, etc, the observation group was treated with autologous bone marrow stem cell transplantation for after treatment 4 weeks on the basis of the control group. The clinical efficacy, serum AFP, CA125, liver function indexes, liver fibrosis indexes and adverse reactions were compared between the two groups. Results: After treatment, the total effective rate in the observation group was significantly higher than those in the control group[84.00%(42/50)vs62.22%(28/45)](P<0.05); the serum AFP and CA125 levels in observation group were significantly lower than those in control group[(4.42±0.75)ng/ml vs(5.88±0.91)ng/ml,(61.09±8.31)U/ml vs(75.63±10.51)U/ml](P<0.05); the indexes of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), glutamyltransferase (GGT) and the indexes of liver fibrosis such as hyaluronic acid (HA), type III procollagen (PCIII), laminin (LN) in the observation group were significantly lower than those in the control group(P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Autologous bone marrow stem cells is well for biliary cirrhosi, which can effectivelyimprove liver function, liver fibrosis, reduce the expression of serum AFP and CA125 levels, and has high safety, it's worth for popularizing.
[1] Kolli S, Mori A, Moshenyat I. Esophageal ulcers in primary biliary cholangitis: a rare cause of hematemesis in the setting of portal hypertension and esophageal varices[J]. Gastroenterology Res, 2018, 11(5): 388~390. [2] Zheng YJ, Pan MX, Wang Y. Clinical significance and correlation of ductular reaction in hepatobiliary diseases[J].Chinese Journal of Hepatology, 2018, 26(8): 637~640. [3] T Tomiyama, GX Yang, M Zhao, et al.The modulation of co-stimulatory molecules by circulating exosomes in primary biliary cirrhosis[J]. Cellular & Molecular Immunology, 2017, 14(3) :276~284. [4] Tsuji K, Kurosaki M, Itakura J, et al. Real-world efficacy and safety of ledipasvir and sofosbuvir in patients with hepatitis C virus genotype 1 infection: a nationwide multicenter study by the Japanese Red Cross Liver Study Group[J].Gastroenterol, 2018, 53(10): 1142~1150. [5] Bell SM, Barnes K, Clemmens H, et al. Ursodeoxycholic acid improves mitochondrial function and redistributes drp1 in fibroblasts from patients with either sporadic or familial alzheimer's disease[J].Mol Biol, 2018, 430(21): 3942~3953. [6] Goossens N, Breguet R, De Vito C, et al. Peribiliary gland dilatation in cirrhosis: relationship with liver failure and stem cell/proliferation markers[J]. Dig Dis Sci, 2017, 62(3): 699~707. [7] 中华医学会肝病学分会,中华医学会消化病学分会,中华医学会感染病学分会.原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015)[J].临床肝胆病杂志,2015,31(12):1980~1988. [8] S Shimoda, S Hisamoto, K Harada, et al. Natural killer cells regulate T cell immune responses in primary biliary cirrhosis[J]. Hepatology, 2016, 62 (6): 1817~1827. [9] 李强,黄玉仙,陈良.原发性胆汁性肝硬化研究现状[J].胃肠病学和肝病学杂志,2017,26(11):1206~1209. [10] F Yang, Q Wang, Z Wang, et al.The natural history and prognosis of primary biliary cirrhosis with clinical features of autoimmune hepatitis[J]. Clinical Reviews in Allergy & Immunology, 2016, 50 (1): 114~123. [11] Tarantino G, Magistri P, Serra V, et al. Laparoscopic liver resection of right posterior segments for hepatocellular carcinoma on cirrhosis[J].Laparoendosc Adv Surg Tech A, 2017, 27(6): 559~563. [12] Koyama Y, Wang P, Liang S, et al. Mesothelin/mucin 16 signaling in activated portal fibroblasts regulates cholestatic liver fibrosis[J].Clin Invest, 2017, 127(4): 1254~1270. [13] GY Minuk, S Liu, K Kaita, et al.Autoimmune hepatitis in a north american aboriginal/first nations population[J]. Canadian Journal of Gastroenterology, 2016, 22 (10): 829~834 [14] Idriss NK, Sayyed HG, Osama A, et al. Treatment efficiency of different routes of bone marrow-derived mesenchymal stem cell injection in rat liver fibrosis model[J]. Cell Physiol Biochem, 2018, 48(5): 2161~2171.