肠内营养联合重组人生长激素治疗腹主动脉瘤术后疲劳综合征

Post Operation Fatigue Syndrome Treated by Nutritional Support with Recombinant Growth Hormone Therapy in Abdominal Aortic Aneurysms Patients

目的探讨接受腹主动脉瘤(AAA)手术的高龄患者,在充足肠内营养支持下,应用重组人生长激素(rhGH)能否减少术后疲劳综合征(POF)的病程。方法选择63例接受腹主动脉瘤手术的高龄患者,严格入选标准后随机分组进行双盲试验。两组术后,予相同标准的肠内营养底物,rhGH组32例术后第三天起予rhGH8IU/d,连续7d。对照组31例予安慰剂,监测患者术后疲劳度、氮平衡、转铁蛋白及体重。结果rhGH组疲劳度(Christensen评分)于术后7,14d均低于对照组(P<0.05);术后7,14drhGH组排氮量明显低于对照组,(P<0.001);术后7,14drhGH组转铁蛋白下降明显低于对照组(P<0.01);两组体重于第7,14d均有下降,两组无显著性差异(P>0.05)。结论术后低剂量应用rhGH有利于减轻接受腹主动脉瘤手术患者术后POF病程,血清转铁蛋白是衡量POF较可靠的生化指标。

Objective To discuss whether recombinant human growth hormone therapy would reduce the course of post operation fatigue （POF） in abdominal aortic aneurysms （AAA） patients with sufficient nutritional support. Methods A total of 63 aged patients who underwent AAA operation were collected strictly and randomly divided into 2 groups, and then were analyzed by two - blind method. Patients in the 2 groups were treated by the same nutritional support. The rhGHgroup was treated with rhGH for 7 d from the 3rd day after operation, and the control group was treated with placebo. Patients scores of POF, nitrogen balance, transferrin level, and weight were monitored. Results The scores of POF in rhGH group at 7, 14 d after operation were lower than those in control group （P 〈0. 05 ）. Nitrogen excretion in rhGH group at 7, 14 d after operation were significantly lower than those in control group （P 〈 0. 01 ）. The level of transferrindecrease in rhGH group at 7, 14 d after operation was significantly lower than that in control group. There were no significant differences between 2 groups in weight loss at 7, 14 d after operation （P 〉 0.05 ）. Conclusion AAA patientsmanaged with low dose rhGH after operation contribute to decrease the course of POF. The level of serum transferrin is a reliable biochemical index for the evaluation of POF.