人工肝支持系统对慢性乙型重型肝炎患者骨髓干细胞分化因子水平的影响

目的 探讨人工肝支持系统(ALSS)对慢性乙型重型肝炎患者血清骨髓干细胞(BMSC)分化因子水平的影响.方法 将50例慢性乙型重型肝炎患者分为ALSS组25例和对照组25例,对照组入院后予内科综合治疗,ALSS组在相同内科综合治疗的基础上于入院1周内开始接受ALSS治疗.采用ELISA法检测两组患者入院时和入院2周时的BMSC分化因子水平.统计学处理采用t检验.结果 ALSS组治疗前血清肝细胞生长因子(HGF)为(689.10±337.68)ng/L,成纤维细胞生长因子-4 (FGF-4)为(124.88±87.67) ng/L,表皮生长因子(EGF)为(323.85±44.40) ng/L,碱性成纤维细胞生长因子(bFGF)为(9.29±1.38)ng/L,治疗后血清HGF为(1081.50±356.66) ng/L,FGF-4为(110.76-79.71) ng/L,EGF为(347.80±71.73)ng/L,bFGF为(9.57±1.15) ng/L,其中HGF显著升高(t=10.042,P＜0.01),且升高幅度大于对照组(t=6.670,P＜0.01),FGF-4、EGF及bFGF改变差异无统计学意义.对照组HGF、FGF-4、EGF及bFGF在治疗前后均差异无统计学意义.结论 ALSS治疗可以提高慢性乙型重型肝炎患者血清HGF水平,同时不影响FGF-4、EGF和bFGF水平,可能有助于BMSC以转分化机制参与重型肝炎的肝细胞修复和再生.

Influence of artificial liver support system on bone marrow stem cell differentiation factors in patients with chronic severe hepatitis B

Objective To study the influence of artifical liver support system (ALSS) on bone marrow stem cell (BMSC) differentiation factors in patients with chronic severe hepatitis B.Methods Fifty patients with chronic severe hepatitis B were divided into ALSS treatment group (n=25) and control group (n=25).The patients in control group received combined medical treatment and those in ALSS treatment group received ALSS treatment within 1 week of admission on the basis of combined medical treatment.The concentrations of hepatocyte growth factor(HGF),fibroblast growth factor-4 (FGF-4),epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) were detected before and 2 weeks after therapy.The data were analyzed by t test.Results The serum levels of HGF,FGF-4,EGF and bFGF of patients before ALSS treatment in treatment group were (689.10± 337.68) ng/L,(124.88±87.67) ng/L,(323.85±44.40) ng/L and (9.29± 1.38) ng/L,respectively; while the levels of those cytokines after ALSS treatment were (1081.50±356.66) ng/L,(110.76±79.71) ng/L,(347.80±71.73) ng/L and (9.57±1.15) ng/L,respectively,among which HGF level increased significantly after ALSS treatment (t =10.042,P＜0.01) and was higher than control group(t=6.670,P＜0.01).However,the levels of HGF,FGF-4,EGF and bFGF were not significantly different from those in the control group.And levels of all HGF,FGF-4,EGF and bFGF in control group were not statistically different before and after treatment.Conclusion ALSS treatment can increase the serum HGF level but not FGF-4,EGF and bFGF,which may contribute to BMSC transdifferentiation that is involved in the hepatocyte repair and regeneration in chronic severe hepatitis B.