关于粒细胞集落刺激因子治疗肝衰竭的临床与机制研究.pdfVIP

传染病信息  2016年12月30日  第29卷  第6期  Infect Dis Info, Vol. 29, No. 6, December 30, 2016  ·375· 关于粒细胞集落刺激因子 治疗肝衰竭的临床与机制研究 胡瑾华     [摘要]　肝衰竭的临床内科救治缺乏特效用药，近期报道称粒细胞集落刺激因子（granulocyte colony-stimulating factor, G-CSF）能有效治疗酒精性肝炎和乙型肝炎（乙肝）肝衰竭，提高患者生存率。相关治疗机制研究显示 G-CSF 能动员骨髓 造血干细胞（hematopoietic stem cells, HSCs）。其中，HSCs 一方面直接分化为肝细胞；另一方面 HSCs 可能通过旁分泌方式 改变肝脏微环境，强化内源性肝卵圆细胞反应性增生，启动内源性修复程序参与肝组织修复。G-CSF 还可能通过抑制肝细 胞凋亡 / 坏死及免疫调节，起到保护肝脏的作用。有必要开展多中心随机对照研究观察 G-CSF 治疗肝衰竭疗效及安全性的 临床试验，为 G-CSF 推广应用提供高级别的循证医学依据。     [关键词]　肝功能衰竭；粒细胞集落刺激因子；细胞凋亡；免疫调节；治疗； 临床研究     [中国图书资料分类号]　R392.114　　　　[文献标志码]　A　　　　[文章编号] 1007-8134(2016)06-0375-03　    　　DOI:10.3969/j.issn.1007-8134.2016.06.014 Study on the mechanism of granulocyte colony-stimulating factor in the treatment of liver failure * HU Jin-hua Liver Failure Treatment and Reaserch Center, 302 Military Hospital of China, Beijing 100039, China *Corresponding author, E-mail: hjh@ 　　 　　[Abstract]　The clinical medical treatment of liver failure is lack of effects of drugs. Recent reports of granulocyte colony- stimulating factor (G-CSF) can be effective in the treatment of liver failure induced by alcoholic hepatitis and hepatitis B virus (HBV), and improve the survival rate of patients. The study of related therapeutic mechanism showed that G-CSF could mobilize bone marrow hematopoietic stem cells (HSCs). Among them, on one hand, HSCs is directly differentiated into hepatocytes; on the other hand, HSCs may change the microenvironment of the liver by paracrine secretion, enhance endogenous hepatic oval cells proliferation and initiate endogenous repair procedures involved in liver tissue repair. G-CSF may also play a role in protecting t