营养支持联合重组人生长激素对机械通气患者营养状况及免疫功能的影响

Effect of nutritional support combined with human growth hormone recombinant on nutritional status and immunological function in patients with mechanical ventilation

目的评估营养支持联合重组人生长激素（rhGH）在机械通气患者中应用的效果。方法ICU住院患者中需机械通气患者共150例，试验组（营养支持联合rhGH）80例，对照组（单纯营养支持）70例，热量按Harris-Benedict公式换算供给，供氮量0．25g／（kg·d），试验组予rhGH0．1U／（kg·d）皮下注射7d，对比研究两组在各营养状况指标、免疫功能指标及临床指标等方面的不同影响。结果治疗后7d，试验组比对照组在各营养状况指标和免疫功能指标方面有明显改善，一次脱机成功率高。治疗后7d，试验组患者转铁蛋白（3,0±0．6）g／L、前白蛋白（226．46±27．02）mg／L、CD，（53．8±3．3）％、CD4（0．41±0．14）％、NK（16．1±2．1）％，均较对照组患者的（1．9±0．4）g／L、（188．68±17．27）mg／L、（47．4±4．1）％、（0．25±0．05）％和（10．9±3．0）％明显升高，差异有统计学意义（P〈0．01）。结论营养支持联合rhGH比单纯营养支持对机械通气患者营养状态的改善具有更佳的疗效，同时对机体的免疫功能也有一定的调理作用。

Objective To evaluate the effects of nutritional support combined with human growth hormone recombinant （rhGH） in patients with mechanical ventilation. Methods One hundred and fifty cases in ICU were randomized into test group （nutritional support combined with rhGH, 80 cases） and control group （nutritional support,70 cases）. Both groups received calories according to Harris-Benedict formula [N,0.25 g/（kg·d）]. In addition, the test group received subcutaneous injections of rhGH at a dose of 0.1 U/ （kg·d） for 7 days. The different effects on nutritional status indexes, immunological function indexes and clinical indexes were compared. Results Compared with the control group,there were significant improvement in nutritional status indexes and immunological function indexes after the treatment of 7 days. The success rate of once weaning was higher in test group than that in control group. There were significant differences in the level of transferrin, prealbumin, CD3, CD4, NK between two groups [ （3.0 ± 0.6 ） g/L vs. （ 1.9 ± 0.4） g/L, （226.46 ± 27.02） mg/L vs.（ 188.68 ± 17.27） mg/L, （53.8 ± 3.3） % vs. （47.4 ±4.1）%,（0.41 ±0.14）%vs. （0.25±0.05）%,（16.1 ±2.1） % vs. （10.9±3.0）%]（P〈0.01）. Conclusion rhGH combined with nutritional support has more effects on improving nutritional status compared with those of single nutritional support. It has significant adjustment effect on immunological function in patients with mechanical ventilation.