重型颅脑损伤早期应用生长激素对其代谢及预后的影响研究

The Study of Early Nutrition and Metabolism in Recombinant Human Growth Hormone on Patients with Severe Craniocerebral Injury

目的探讨重组人生长激素(rhGH)对重型颅脑损伤患者代谢调控作用的应用价值。方法将40例重型颅脑损伤患者在早期肠内、肠外营养支持的基础上随机分成rhGH治疗组(20例)与对照组(20例),rhGH治疗组伤后或术后第2～3天开始每日皮下注射重组人生长激素4 IU,共10～14d。应用后第7、14天检测血清总蛋白、白蛋白、转铁蛋白及前白蛋白。结果 rhGH治疗组第14天后血清总蛋白、白蛋白、转铁蛋白及前白蛋白浓度高于对照组,体质量改变率低于对照组,预后优于对照组。结论重型颅脑损伤患者应用rhGH能改善机体对营养底物的利用率,促进蛋白合成、减轻重型颅脑损伤后低蛋白血症,改善预后。

Objective To study the effect in metabolism of recombinant human growth hormone on patients with severe craniocerebral injury.Methods Forty patients with severe craniocerebral injury were randomized to receive（n=20） or not to receive rhGH（n=20） by adequate nutritional support.From 2-3 day after injury or postoperation,patients in rhGH group received daily subcutaneous doses of rhGH 4IU for 10～14 days.Serum total protein,albumin,prealbumin and transferrin were detected at seventh day and fourteenth day after giving rhGH.Results Those receiving rhGH demonstrated an increase in serum total protein,albumin,prealbumin and body weight changement,transferrin compared with control group at fourteenth day.Conclusion Data indicate that rhGH improved nutritional supplements utilization efficiency,stimulate protein synthesis and decreased the occurrence of secondary hypoproteinemia after severe craniocerebral injury,and improve the prognosis.