重组人生长激素对慢性阻塞性肺疾病营养不良无创通气患者营养状况的影响

The effect of recombinant human growth hormone in malnutritional COPD patients with noninvasive-mechanical ventilation

目的探索重组人生长激素能否改善慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)无创通气患者的营养状况。方法选取COPD营养不良患者50例,随机分为对照组26例,治疗组24例。两组患者均予氧疗、抗感染、化痰、支气管扩张及营养支持等常规治疗,治疗组每晚临睡前皮下注射重组人生长激素(rhGH)0.1IU·kg-1,共7d。比较两组患者营养状况、血淋巴细胞计数、血气分析等。结果治疗组患者的前白蛋白(2.2±0.2)g·L-1、动脉血氧分压(75.2±7.3)mmHg和动脉血二氧化碳分压(46.4±4.8)mmHg均较对照组〔(2.1±0.2)g·L-1,(65.8±7.8)mmHg,(50.8±6.9)mmHg〕有明显改善。结论重组人生长激素能促进蛋白合成、改善营养状况,提高动脉血氧分压,降低动脉血二氧化碳分压,有助于COPD无创通气患者的治疗。

OBJECTIVE To evaluate the effects of recombinant human growth hormone by divided（rhGH） in patients with noninvasive-mechanical ventilation.METHODS Fifty cases were randomized into test group（nutritional support combined with rhGH,24 cases） and control group（nutritional support,26 cases）.Both groups received oxygen therapy,anti-infection,eliminate sputum,bronchodilatation and nutrition support.In addition,the test group received subcutaneous injections of rhGH at a dose of 0.1U/（kg·d） for 7 days.The different effects on nutritional status indexes,lymphocyte count and blood gas analysis were compared.RESULTS Compared with the control group,there were significant improvement in nutritional status indexes and blood gas analysis after the treatment of 7 days.There were significant differences in the level of prealbumin,arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide between two groups（（2.2±0.2）g·L-1 vs.（2.1±0.2）g·L-1,（75.2±7.3）mmHg vs.（65.8±7.8）mmHg,（46.4±4.8）mmHg vs.（50.8±6.9）mmHg）.CONCLUSION rhGH has more effects on improving nutritional status.It conduce to COPD with noninvasive-mechanical ventilation.