重组人生长激素和人血白蛋白对肝硬化失代偿的疗效比较

Therapeutic Effect Comparison of Recombinant Human Growth Hormone and Human Serum Albumin in Decompensative Liver Cirrhosis

目的考察重组人生长激素与人血白蛋白对失代偿期肝硬化的治疗效果。方法将42例白蛋白低于35g/L的失代偿期肝硬化患者随机分为两组,生长激素治疗组:20例,予重组人生长激素4IU,肌注,1次/2d,疗程30天;白蛋白治疗组:22例,予20%人血白蛋白50ml,静滴,2次/周,疗程30天。两组患者同时予相同保肝、对症治疗。于治疗第15天、30天、60天、90天测定各项指标。结果 15天时,白蛋白组血清白蛋白含量上升(P<0.05);30天时,两组患者血清白蛋白含量均上升(P<0.05);60天后,生长激素治疗组血清白蛋白水平升至最高点,白蛋白治疗组较前降低,两组间差异有统计学意义(P<0.01);90天后生长激素治疗组血清白蛋白含量仍维持较高,且肝功能好转,而白蛋白治疗组降至治疗前水平。结论重组人生长激素与人血白蛋白均可明显提高失代偿期肝硬化血清白蛋白水平,但重组人生长激素,对肝硬化失代偿的治疗作用,中远期疗效更好。

Objective To compare the therapeutic effects of recombinant human growth hormone and human serum albumin on decompensative liver cirrhosis.Methods Forty-two patients diagnosed as decompensative liver cirrhosis with sera albumin below 35 g/L,were randomly divided into two groups.Besides conventional liver-protecting treatment,20 were treated by recombinant human growth hormone 4 IU,intramuscular injection,once every two days,30 days as a period of treatment;22 cases were treated by 20% human serum albumin 50 ml,intravenous injection,twice a week,30 days as a period of treatment.On 15,30,60 and 90 days of the treatment,albumin,alanine aminotransferase（ALT） and others indexes were tested.Results On the 15th day,the serum albumin was increased only in albumin group（P0.05）.On the 30th day,the serum albumin was increased in both groups（P0.05）.But on the 60th day,the serum albumin remained to increase and reached to peak in growth hormone group;on the contrary the serum albumin was decreased in albumin group and the difference between two groups was significant（P0.01）.On the 90th day,the serum albumin remained to be high and the liver function was improved in growth hormone group;the serum albumin was decreased to the level before treatment in albumin group.Conclusion Both recombinant human growth hormone and human albumin can improve the liver functions of patients with decompensative liver cirrhosis.The recombinant human growth hormone has better long-term therapeutic effects than the human albumin.