*Applied Research Associates, Inc., 801 N. Quincy St., Suite 700, Arlington, VA, 22203.
Health Phys. 2014 Jun;106(6):699-703. doi: 10.1097/HP.0000000000000090.
Depression of hematopoietic elements due to significant levels of whole-body or partial-body irradiation due to radiation-induced suppression of mitosis in the stem and progenitor cells can result in life-threatening injury. Successful administration of intensive care of patients experiencing acute radiation sickness (ARS; also called acute radiation syndrome) is dependent upon the ability to stimulate the recovery of surviving hematopoietic stem cells (HSC), assuming the non-hematopoietic injuries are also survivable with treatment. To date, there have been a number of studies involving radiation accidents where patients were treated with cytokines. Although the data overall seem to indicate that the period of neutropenia is shortened and survival prolonged, so far there is no statistically significant proof that cytokine administration actually decreases mortality in radiation-injured humans. Some studies have shown no improved survival when used in a mouse model; however, studies in canines and primates have shown improved survival. CSF therapy is considered a valuable adjunct to treatment with antibiotics and strict hygiene controls in certain irradiated patients. It appears that these drugs do shorten the periods of neutropenia in irradiated patients and must be considered part of the therapeutic armamentarium in the treatment of ARS in a mass casualty situation. Based on review of the human experience with G-CSF and GM-CSF, as well as some animal studies, current consensus opinions support the prompt administration of these materials to patients suffering significant bone marrow depression from exposure to ionizing radiation.
由于全身或局部照射导致的造血元素减少，由于辐射诱导的干细胞和祖细胞有丝分裂抑制，可能导致危及生命的损伤。成功地对急性放射病（ARS；也称为急性辐射综合征）患者进行重症监护取决于刺激存活的造血干细胞（HSC）恢复的能力，假设非造血损伤也可以通过治疗存活。迄今为止，已有许多涉及辐射事故的研究，其中患者接受了细胞因子治疗。尽管总体数据似乎表明中性粒细胞减少症的持续时间缩短，生存率延长，但迄今为止，没有统计学证据表明细胞因子给药实际上降低了辐射损伤人类的死亡率。一些研究表明，在小鼠模型中使用时并未提高生存率；然而，犬类和灵长类动物的研究表明生存率有所提高。CSF 治疗被认为是在某些接受照射的患者中联合使用抗生素和严格卫生控制的有价值的辅助治疗方法。这些药物似乎缩短了照射患者的中性粒细胞减少症持续时间，并且必须被视为大规模伤亡情况下治疗 ARS 的治疗武器库的一部分。基于对 G-CSF 和 GM-CSF 的人类经验以及一些动物研究的回顾，目前的共识意见支持对因暴露于电离辐射而遭受严重骨髓抑制的患者及时给予这些物质。
