基因重组人生长激素对严重烧伤后的康复作用

The therapeutic role of recombinant human growth hormone(rhGH) in severe burns

目的 探讨基因重组人生长激素 (rhGH)对蛋白质合成的影响及其在严重烧伤病人治疗中的作用。方法 选择 28例烧伤总面积 >35％ TBSA, III度面积 >15％ TBSA病人作为观察对象 ,随机分组 ,治疗组 (rhGH组 )15例和对照组 13例。 rhGH组病人术后每日由皮下按照 0.2 IU/kg。给予 rhGH治疗共 10 d,对照组按相同方法给 2 ml生理盐水作安慰剂对照 ,伤后观察病人一般状况 ,测血常规、血生化、肝功 (包括谷丙转氨酶 ALT),植皮区、供皮区创面愈合时间及住院日期。结果 rhGH治疗组供、植皮区创面愈合时间缩短，血浆总蛋白、白蛋白浓度提高，全身感染并发症例数减少，差异显著。结论 rhGH可有效促进血浆蛋白质的合成，纠正机体负氮平衡，减少全身感染并发症、内脏并发症发生机会，促进创面愈合，缩短住院时间。

Objective The purpose of this study was to investigate the therapeutic role of recombinant human growth hormone(rhGH)in severe burns and the effect of rhGH on protein syntheses. Method 28 burning patients, whose total body burning area was more than 15％ total body surface area(TBSA) and III° body burning area more than 15％ TBSA, were randomly divided into treatment group(n=15) and control group(n=13). After operation, the treatment group received subcutaneous injection of rhGH at dosage of 0.2 IU/kg· d for 10 days and the control group received 2ml normal saline for placebo. The blood routine test, blood biochemical test, and liver function(ALT) were examined on day 1,7,14 and 21. The healing time of donor skin and graft skin and the duration of hospitalization were also recorded.Result Plasma protein and albumin increased significantly in treatment group compared with control group on day 1,7,14 and 21. The healing time of donor skin and graft skin and the duration of hospitalization shortened significantly in treatment group compared with control group. The incidence of systemic infection and internal organ injuries were lower in treatment group than in control group. Conclusion rhGH could improve protein syntheses, correct negative nitrogen balance, decrease the incidence of systemic infection and internal organ injuries, ameliorate the healing of wound, and shorten the duration of hospitalization.