四种生长激素对重度烧伤患者血糖的影响

Effects of four somatropins on blood sugar in severely burned patients

目的探讨不同生长激素对重度烧伤患者血糖的影响。方法选取我院1999年1月～2007年12月间收治的既往无糖尿病史的重度烧伤住院患者共630例，随机分为9组（n=70），其中8组分别使用4种不同生产技术生产的生长激素，每种生长激素设0．15U·kg^-1·d^-1和0．2U·kg^-1·d^-1两个剂量组，空白对照组使用等量生理盐水。入院4周内，观察并比较各组患者血糖水平和胰岛素用量的变化。结果共571例患者完成试验。各组平均血糖控制水平差异无统计学意义（P〉0．05）。各治疗组比空白对照组平均胰岛素用量明显增多（P〈0．01）；在应用同种生长激素的情况下，使用剂量为0．2U·kg^-1·d^-1的治疗组比使用剂量为0．15U·kg^-1·d^-1的治疗组患者平均胰岛素用量也明显增多（P〈0．01）。除空白对照组外，其他各治疗组停用生长激素后血糖均恢复到正常值范围之内且不需要胰岛素控制，恢复至正常的时间差异无统计学意义（P〉0．05）。结论重度烧伤患者血糖水平与生长激素的使用剂量呈正相关；不同技术生产的生长激素对重度烧伤患者血糖影响基本相同；规范应用生长激素进行治疗，不会导致糖尿病。

Objective To investigate the effects of four somatropins on blood sugar in severely burned patients. Methods Totally 630 patients without history of diabetes hospitalized in the Third Hospital of Wenzhou Medical College from January 1999 to December 2007 were recruited and randomly divided into 9 groups （n =70）. Eight groups received 4 different somatropins, and each somatropin had two doses： 0. 15 U· kg^-l · d^-1 and 0. 2 U ·kg^-1·d^ -1. The control group received normal saline. Blood sugar and insulin amount were observed and analyzed. Results Among 630 patients, 571 finished the trial. The average blood sugar level among different groups was not significantly different （ P 〉 0. 05 ）. The insulin usage significantly increased in treatment groups than in control group （ P 〈 0. 01 ）. For groups using the same somatropin, the insulin usage was significantly higher in 0. 2 U · kg^-1· d^-1 dosing group than in 0. 15 U ·kg^-1 · d^-1 dosing group （P〈0.01）. In the treatment groups, once somatropin was withdrawn, the blood sugar level returned normal, and even no insulin was needed. The re- covery time was not significantly different among groups （ P 〉 0.05 ）. Conclusions The blood sugar level is positively correlated with the amount of somatropin in severely burned patients. Such effect is not different among somatropins manufactured with different techniques. Standardized application of somatrupins will not induce diabetes.