重组人生长激素对严重烧伤患者体液分布及水钠潴留的影响

Influence of recombinant human growth hormone on body fluid compartments and water-sodium retention in severe burn patients

目的了解重组人生长激素（rhGH）对严重烧伤患者体液分布及水钠潴留的影响。方法成年重度烧伤患者30例，按区组随机法分为治疗组和对照组。伤后第7天开始分别为2组患者皮下注射rhGH（12U／d）和等量等渗盐水，持续14d。于伤后第7天（用药前）及伤后第14、21天（用药后第7、14天），应用生物电阻抗法观察2组患者机体总水量（TBW）、细胞内水量（ICW）及细胞外水量（ECW），同时应用离子选择电极法测量24h尿钠，进行对比分析和综合统计。结果治疗组与对照组比较，伤后第7、14、21天的TBW、ICW、ECW及24h尿钠变化差异无统计学意义（P〉0．05），各组内不同时相点比较，差异亦无统计学意义（P〉0．05）。但将2组患者数据合并进行统一处理后，伤后第21天TBW值和ICW值分别为（36±6）、（21±4）L，与伤后第7天[（38±6）、（254-7）L]比较，差异有统计学意义（P〈0．01）。结论重度烧伤患者随着病程延长，TBW和ICW逐渐减少，适量应用rhGH对患者体液分布和水钠潴留无明显影响。

Objective To investigate the influence of recombinant human growth hormone（rhGH） on body fluid compartments and water-sodium retention in severe burn patients. Methods Thirty adult patients with severe burn were divided into treatment（T） and control （C）groups by block randomized design. Patients in both groups were subcutaneously injected with same amount of rhGH （ 12 IU/d） or isotonic saline during 7 - 21 post burn day （ PBD ）. The total body water（ TBW ） , intracellular water（ ICW ） , extracellular water（ECW） were measured by bioelectrical impedance analysis（BIA） on 7,14,21 PBD. The 24 h uninary output of Na^＋ was determined by ion selective electrode method（ISE）. Results There were no significant difference in levels of TBW, ICW, ECW and 24 h uninary output of Na^＋ between two groups on 7,14,21 PBD （P〉0.05）. No difference in results was found between groups at different time points （ P 〉 0. 05 ）. After the data were analyzed, the level of TBW（36±6L） ,ICW（21±4 L） on 21 PBD were evidently lower than those on 7 PBD （38±6 L,23±7 L, P 〈0.01）. Conclusion The level oflCW and TBW in severe burn patients decreased along with the time. Proper dosage of rhGH has no significant effect on body fluid comoartments and water-sodium retention.