Résumé
Objective To evaluate the efficacy and safety of autologous peripheral blood stem cell transplantation (APBSCT) in treatment of patients with decompensated hepatitis B cirrhosis.Methods Sixty two patients with decompensated hepatitis B cirrhosis admitted in Ningbo Second Hospital during January 2010 and December 2013 were enrolled in the study.Patients were randomly assigned in two groups: 50 patients in control group received comprehensive medical treatment only, and 12 patients in combination group received APBSCT on the basis of medical treatment.The levels of serum total bilirubin (TBil), albumin (Alb), alanine aminotransferase (ALT) and prothrombin time (PT) in two groups were mearsured at the 4th,12th,24th week.Overall survival (OS),progression-free survival (PFS) and complications were compared between two groups after 3 years follow-up.SPSS17.0 software was used to analyze the data.Results After APBSCT treatment, the level of Alb and PT at week 4,12 and 24 in combination group improved significantly(tAlb=-4.437,-5.210 and-6.915,tPT=12.083,11.251 and 10.640,all P<0.01),there were also significant differences between combination group and control group (tAlb=4.985, 5.565 and 6.260,tPT =-3.013、-3.727 and-3.983,all P<0.01).The 3-year OS and 3-year PFS of patients in combination group were higher than those of control group [(90.9±8.7)%vs.(60.7±7.4)%, (75.8±12.5)% vs.(47.9±7.3)%](χ2=6.887 and 5.565,P<0.05).Besides,APBSCT had more advantages than control group in reducing ascitic fluid and hepatic encephalopathy(χ2=7.992 and 4.681,P<0.05 or <0.01).Conclusion APBSCT combined with medical treatment can improve liver function and 3-year survival rate with mild adverse reaction in patients with decompensated hepatitis B cirrhosis.