Al Mahtab Mamun, Mn Alam Sheikh, L Moben Ahmed, Raihan Ruksana, A Alam Mohammad, A Rahim Mohammad, H Uddin Mohammad, Fazle Akbar Sheikh Mohammad
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Department of Medicine, Kurmitola General Hospital, Dhaka, Bangladesh.
Euroasian J Hepatogastroenterol. 2017 Jan-Jun;7(1):113-115. doi: 10.5005/jp-joumals-10018-1229. Epub 2017 May 5.
Decompensated cirrhosis is associated with significantly high mortality resulting from hepatic failure, and liver transplantation seems to be the only viable indication for its management. The objective of this study is to assess if granulocyte colony-stimulating factor (G-CSF), a stimulatory of stem cell may be of any benefit for patients with decompensated cirrhosis of liver.
Seventeen consecutive patients with decompensated cirrhosis of liver were recruited in this prospective study. They received injection of G-CSF (30 IU) over a period of 6 weeks (12 injections) in addition to standard of care.
Patients were followed up at the end of treatment and at 12 weeks of treatment. Treatment was well tolerated, and no significant adverse event was recorded in any patient. Fifteen out of 17 (88%) patients were alive at last follow-up. Although serum bilirubin, albumin, and prothrombin time improved in some patients, statistically significant improvement of Child-Pugh score could not be documented.
The study establishes the safety of G-CSF therapy in patients with decompensated cirrhosis of liver. Besides, such therapy may also have survival benefit, although long-term follow-up is needed to assess its real utility in clinical perspectives. Al Mahtab M, Alam SMN, Moben AL, Raihan R, Alam MA, Rahim MA, Uddin MH, Akbar SMF. Therapy Targeting Stem Cell in Patients with Decompensated Cirrhosis of Liver in a Tertiary Treatment Care Center of Bangladesh. Euroasian J Hepato-Gastroenterol 2017;7(1):113-115.
失代偿期肝硬化与因肝衰竭导致的显著高死亡率相关,肝移植似乎是其治疗的唯一可行指征。本研究的目的是评估粒细胞集落刺激因子(G-CSF),一种干细胞刺激剂,对失代偿期肝硬化患者是否有益。
本前瞻性研究纳入了17例连续的失代偿期肝硬化患者。除了标准治疗外,他们在6周内接受了G-CSF(30 IU)注射(共12次注射)。
在治疗结束时和治疗12周时对患者进行随访。治疗耐受性良好,任何患者均未记录到显著不良事件。17例患者中有15例(88%)在最后一次随访时存活。虽然部分患者的血清胆红素、白蛋白和凝血酶原时间有所改善,但Child-Pugh评分的统计学显著改善未得到证实。
本研究证实了G-CSF治疗失代偿期肝硬化患者的安全性。此外,这种治疗可能也有生存益处,尽管需要长期随访以从临床角度评估其实际效用。阿尔·马赫塔卜M、阿拉姆SMN、莫本AL、拉伊汉R、阿拉姆MA、拉希姆MA、乌丁MH、阿克巴SMF。孟加拉国一家三级治疗中心对失代偿期肝硬化患者的干细胞靶向治疗。《欧亚肝脏胃肠病学杂志》2017年;7(1):113 - 115。