粒细胞集落刺激因子治疗急性慢性肝衰竭患者的治疗意义：

StephenW

Hepatology International

November 2017, Volume 11, Issue 6, pp 540–546 | Cite as
Therapeutic implications of granulocyte colony stimulating factor in patients with acute-on-chronic liver failure: increased survival and containment of liver damage

    Authors
    Authors and affiliations

    Biplob Kumar SahaMamun Al MahtabSheikh Mohammad Fazle AkbarEmail authorSheikh Mohammad Noor-E-AlamAyub Al MamunSharker Mohammad Shahadat HossainMohammad Ashraful AlamAhmed Lutful MobenFaiz Ahmad KhondakerForhadul Islam ChowdhuryRuksana RaihanSalimur RahmanAshok Kumar ChoudhuryAPASL ACLF working party

    Biplob Kumar Saha        1
    Mamun Al Mahtab        1
    Sheikh Mohammad Fazle Akbar        2 3 Email author
    Sheikh Mohammad Noor-E-Alam        1
    Ayub Al Mamun        1
    Sharker Mohammad Shahadat Hossain        1
    Mohammad Ashraful Alam        1  
  Ahmed Lutful Moben        1
    Faiz Ahmad Khondaker        1
    Forhadul Islam Chowdhury        1
    Ruksana Raihan        1
    Salimur Rahman        1
    Ashok Kumar Choudhury        4
    APASL ACLF working party
    1.Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
    2.Department of Medical SciencesToshiba General HospitalTokyoJapan
    3.Miyakawa Memorial Research FoundationTokyoJapan
    4.Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia

Original Article
First Online: 24 August 2017

    167 Downloads

Abstract
Background and purpose

Mobilization of bone marrow-derived stem cells by granulocyte colony stimulating factor (G-CSF) supports hepatic regeneration and may augment clinical improvement in patients with acute-on-chronic liver failure (ACLF). The aim of this study is to assess the impact of G-CSF on complications and transplant-free survival in patients with ACLF.
Methods

Thirty-two patients with ACLF defined by Asian Pacific Association for the Study of the Liver (APASL) criteria were openly randomized to control (group A) or intervention (group B) receiving G-CSF (5 μg/kg/day, for 6 consecutive days) in addition to standard medical therapy with antiviral drugs. The patients were followed for 90 days.
Results

Simultaneous use of G-CSF and antiviral drugs in hepatitis B virus (HBV) ACLF significantly improved survival over antiviral drugs alone. Incidence of hepatorenal syndrome and hyponatremia were reduced due to use of G-CSF. Baseline parameters of the two groups of patients were comparable. Child–Turcotte–Pugh (CTP) and Model for End-Stage Liver Disease (MELD), disease severity scores improved in patients treated with G-CSF, with significant difference only for the CTP score at 90 days follow-up. In addition, mean white blood cell (WBC) count at day 15 was significantly higher in G-CSF group in absence of infection compared with control group.
Conclusions

G-CSF therapy improved survival and clinical recovery in HBV-ACLF. G-CSF therapy also prevented renal failure and hyponatremia. We strongly recommend use of G-CSF therapy in addition to standard medical therapy.
Keywords
Acute-on-chronic liver failure Liver damage Granulocyte colony stimulating factor (G-CSF)

StephenW

国际肝病学

2017年11月，第11卷，第6期，第540-546页|引用为
粒细胞集落刺激因子治疗急性慢性肝衰竭患者的治疗意义：增加存活率和控制肝损伤

    作者
    作者和从属关系

    Biplob Kumar SahaMamun Al MahtabSheikh Mohammad Fazle Akbar电子邮件作者穆罕默德努尔E-AlamAyub Al MamunSharker穆罕默德Shahadat HossainMohammad Ashraful AlamAhmed Lutful MobenFaiz艾哈迈德KhondakerForhadul伊斯兰教ChowdhuryRuksanaRaihanSalimur Ra​​hmanAshok库马尔ChoudhuryAPASL ACLF工作组

    Biplob Kumar Saha 1
    马蒙·马哈塔布1
    谢赫·穆罕默德·法兹勒·阿克巴尔2 3电子邮件作者
    谢赫·穆罕默德·努尔 - 阿拉姆1
    Ayub Al Mamun 1
    Sharker穆罕默德Shahadat侯赛因1
    穆罕默德阿什拉姆1
  Ahmed Lutful Moben 1
    Faiz Ahmad Khondaker 1
    Forhadul Islam Chowdhury 1
    Ruksana Raihan 1
    Salimur拉赫曼1
    Ashok Kumar Choudhury 4
    APASL ACLF工作组
    1.Bangabandhu Sheikh Mujib医科大学DhakaBangladesh
    2.医学科学部东芝总医院东京日本
    3.Miyakawa纪念研究基金会东京日本
    4.肝胆科学系新德里印度肝胆病研究所

来源文章
首次在线：2017年8月24日

    167下载

抽象
背景和目的

通过粒细胞集落刺激因子（G-CSF）动员骨髓来源的干细胞支持肝再生，并且可能增加急性慢性肝衰竭（ACLF）患者的临床改善。本研究的目的是评估G-CSF对ACLF患者并发症和无移植生存率的影响。
方法

将亚太肝病研究协会（APASL）标准定义的32例ACLF患者随机分为对照组（A组）和干预组（B组），分别接受G-CSF（5μg/ kg /连续几天）除了用抗病毒药物的标准药物治疗。随访90天。
结果

在乙肝病毒（HBV）中同时使用G-CSF和抗病毒药物ACLF显着改善了单用抗病毒药物的存活率。由于使用G-CSF，肝肾综合征和低钠血症的发生率降低。两组患者的基线参数是可比的。 Child-Turcotte-Pugh（CTP）和终末期肝病模型（MELD），G-CSF治疗组患者疾病严重程度评分改善，仅90天随访时CTP评分有显着性差异。另外，与对照组相比，在没有感染的情况下，G-CSF组在第15天的平均白细胞（WBC）计数显着更高。
结论

G-CSF治疗改善了HBV-ACLF的生存和临床恢复。 G-CSF治疗也可以预防肾功能衰竭和低钠血症。除了标准的药物治疗，我们强烈推荐使用G-CSF治疗。
关键词
急性慢性肝衰竭肝损伤粒细胞集落刺激因子（G-CSF）