Tsuji Yoshiyasu, Kumashiro Ryukichi, Ishii Kunihide, Arinaga Teruko, Sakamoto Yoshihiro, Tanabe Ryo, Ogata Kei, Koga Yuriko, Ide Tatsuya, Ono Naofumi, Tanaka Eisuke, Abe Hirohiko, Sata Michio
Department of Radiology, Kurume University, School of Medicine, Kurume, Fukuoka, Japan.
Alcohol Clin Exp Res. 2003 Aug;27(8 Suppl):26S-31S. doi: 10.1097/01.ALC.0000078607.32247.9D.
The prognosis of severe alcoholic hepatitis is poor, and there is no established method for a cure.
A 34-year-old man was admitted to Kurume University Hospital because of severe liver dysfunction due to excess alcohol intake. He was treated with prednisolone and two sessions of granulocyte and monocyte adsorption apheresis (GCAP) using an Adacolumn, which removes leukocytes--especially granulocytes and monocytes--from the peripheral blood. We evaluated the changes in the serum levels of interleukin-6, interleukin-8, tumor necrosis factor-alpha, and soluble intercellular adhesion molecule-1, as well as the conventional liver tests and peripheral white blood cell count.
Prednisolone was effective in the short term but resulted in an increase in C-reactive protein (CRP), peripheral leukocytes, and serum total bilirubin. GCAP performed on the 34th and 41st hospital days produced decreases in the white blood cell count, total bilirubin, and intercellular adhesion molecule-1. The patient survived, despite the expected poor prognosis on admission.
GCAP is recommended as a potential therapeutic option for severe alcoholic hepatitis.
严重酒精性肝炎的预后较差，且尚无已确立的治愈方法。
一名34岁男性因过量饮酒导致严重肝功能不全入住久留米大学医院。他接受了泼尼松龙治疗，并使用Adacolumn进行了两疗程的粒细胞和单核细胞吸附去除术（GCAP），该装置可从外周血中去除白细胞，尤其是粒细胞和单核细胞。我们评估了白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α和可溶性细胞间黏附分子-1的血清水平变化，以及传统肝功能检查和外周白细胞计数。
泼尼松龙在短期内有效，但导致C反应蛋白（CRP）、外周白细胞和血清总胆红素升高。在住院第34天和第41天进行的GCAP使白细胞计数、总胆红素和细胞间黏附分子-1降低。尽管入院时预后预期较差，但该患者存活下来。
GCAP被推荐作为严重酒精性肝炎的一种潜在治疗选择。
