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目的：研究自体骨髓干细胞移植对肝硬化凝血、肝功能及转归的影响。方法选择2013年10月至2015年7月平顶山市第一人民医院收治的失代偿期肝硬化且接受自体骨髓干细胞移植治疗的患者54例，入院后均行骨髓穿刺术并收集150～200 ml骨髓，制成20 ml的细胞悬液，行数字减影血管造影（DSA）和股动脉穿刺检查肝脏动脉血管，将干细胞悬液经肝动脉缓慢滴注入肝内。注射后住院和随访观察10周并定期复查，记录随访结局并比较移植前后的凝血功能指标[凝血酶原时间（PT）、凝血酶时间（TT）、凝血活酶时间（APTT）、纤维蛋白原（FIB）]、肝功能指标[血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）、血清白蛋白（ALB）]变化。结果54例患者自体骨髓干细胞移植术均取得成功，腹水及消化道症状有效改善，治疗仅出现恶心呕吐、低热等轻度不良反应，不良反应发生率14.81%；移植术10周后PT（16.03±3.85）s、TT（23.35±2.65）s、APTT（38.24±3.14）s，分别较移植前的（17.78±4.25）s、（25.31±3.03）s、（41.35±4.06）s低，FIB（2.38±0.75）g/L较移植前的（2.02±0.88）g/L高，差异有显著统计学意义（P<0.05）；移植术10周后肝功能指标ALT（81.37±19.42）U/L、AST（59.82±18.64）U/L、TBIL（34.21±15.52）μmol/L，分别较移植前的（92.42±22.15）U/L、（72.51±32.27）U/L、（43.76±24.35）μmol/L低，差异有显著统计学意义（P<0.05），ALB较移植前高但二者相较差异无统计学意义（P>0.05）。结论自体骨髓干细胞移植具有手术成功率高、安全性高等优点，能较好地调节、改善肝硬化患者的凝血功能和肝功能，对促进病情转归、改善生活质量等具有重要意义。

ObjectiveTo study the effects of autologous bone marrow stem cell transplantation on coagulation, liver function and prognosis of patients with liver cirrhosis.Methods From October 2013 to July 2015,54 patients with liver cirrhosis treated were studied in the Pingdingshan First People's Hospital. After admission, all patients underwent bone marrow puncture and about 150 to 200 ml bone marrow was collected. After conventional anticoagulation and separation, about 20 ml cell suspension was made. Digital subtraction angiography (DSA) and femoral artery puncture were performed to examine the hepatic artery. The stem cell suspension was injected slowly into the liver via the hepatic artery. After injection, all patients were observed for 10 weeks during hospitalization and follow-up, and periodic review was performed. The follow-up outcome was recorded. The coagulation function indexes [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB)] and liver function indexes [serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), serum albumin (ALB)] were compared before and after transplantation.Results Autologous bone marrow stem cell transplantation was successful in 54 patients. Ascites and digestive tract symptoms were relieved effectively. There only were nausea and vomiting, low fever and other mild adverse symptoms, and the incidence of adverse symptoms was 14.81%; 10 weeks after transplantation, coagulation function indexes [PT (16.03±3.85) s, TT (23.35±2.65) s, APTT (38.24±3.14) s] were lower than those before transplantation while FIB [(2.38±0.75) g / L] was higher than that before transplantation [(2.02±0.88) g/L] (P<0.05); 10 weeks after transplantation, liver function indexes [ALT (81.37±19.42) U/L, AST (59.82±18.64) U/L, TBIL (34.21±15.52) μmol/L] were lowerthan those before transplantation [(92.42±22.15) U/L, (72.51±32.27) U/L, (43.76±24.35) μmol/L] (P<0.05). ALB was higher than that before transplantation but there were no significant differences between the two (P>0.05).Conclusions Autologous bone marrow stem cell transplantation is with advantages of high success rate of operation and high safety, etc.It can better regulate and improve coagulation function and liver function in patients with liver cirrhosis. It is of important significance in promoting outcome and improving the quality of life.