吉粒芬治疗终末期肝病合并脓毒血症临床疗效及免疫学机制研究  

Study of gemcitabine in end-stage liver disease with sepsis

作　　者：武瑞 萧云蕾 傅晓晴 WU Rui;XIAO Yunlei;FU Xiaoqing(Department of Severe Liver Disease,Hangzhou Xixi Hospital,Hangzhou 310023,Zhejiang,China)

机构地区：[1]杭州市西溪医院重症肝病科,浙江杭州310023

出　　处：《中国现代医生》2024年第20期104-107,112,共5页China Modern Doctor

基　　金：国家“十三五艾滋病和病毒性肝炎等重大传染病防治”科技重大专项(2017ZX10302201);杭州市生物医药和健康产业发展扶持科技专项(2021WJCY365)。

摘　　要：目的观察吉粒芬(recombinant human granulocyte colony-stimulating factor,rhG-CSF)在终末期肝病(end-stage liver disease,ESLD)合并脓毒血症中临床疗效及预后影响。方法选取2022年1月至2023年12月ESLD合并脓毒血症患者90例,采用简单随机抽样法分成rhG-CSF组、胸腺肽针组、对照组,每组30例。比较三组间治疗前后肝功能、细胞因子水平、治疗有效率、并发症及ESLD模型(model for end-stage liver disease,MELD)评分系统。结果rhG-CSF组治疗总有效率为96.67%,明显高于另外两组,差异有统计学意义(P<0.05)。治疗后,rhG-CSF组、胸腺肽组肝功能、细胞因子水平及免疫功能恢复情况均优于对照组,差异有统计学意义(P<0.05)。治疗及随访12周后,rhG-CSF组并发症最少,病死率最低。结论rhG-CSF辅助治疗ESLD合并脓毒血症临床疗效佳,可增强抗感染能力,改善预后。Objective To observe the effect and prognosis of recombinant human granulocyte colony-stimulating factor(rhG-CSF)in end-stage liver disease(ESLD)with sepsis.Methods Ninety patients with ESLD complicated with sepsis from January 2022 to December 2023 were selected and randomly divided into rhG-CSF group,thymosin group and control group,with 30 cases each.Compare the liver function,cytokine levels,treatment efficacy,complications,and ESLD model(MELD)scoring system before and after treatment among three groups.Results The total effective rate of rhG-CSF group was 96.67%,which was significantly higher than the other two groups,and the difference was statistically significant(P<0.05).After treatment,the liver function,cytokine levels,and immune function recovery of the rhG-CSF group and thymosin group were better than that of control group,with statistical significance(P<0.05).After 12 weeks of treatment and follow-up,the least complications and the lowest mortality rate in the rhG-CSF group.Conclusion The clinical efficacy of rhG-CSF as an adjuvant therapy for ESLD complicated with sepsis is excellent,which can enhance anti-infection ability and improve prognosis.

关 键 词：终末期肝病 脓毒血症 重组人粒细胞刺激因子 

分 类 号：R575.3[医药卫生—消化系统]