生长激素在慢性消耗性疾病中的作用

Application of rhGH in the treatment of chronic wasting diseases

目的 :观察生长激素在慢性消耗性疾病中的作用。 方法 :选择需营养支持的慢性消耗性疾病病人 2 2例 ,其中慢性阻塞性肺部疾病 (COPD)伴或不伴肺心病 1 0例 ,脑梗死 (CI)或脑出血 (CH)恢复期合并褥疮 1 2例 ,年龄60～ 75岁 ,伴中重度营养不良 ,随机分为对照组和试验组。对照组给予常规临床治疗和营养治疗 ,试验组在此基础上加用重组人生长激素 (rhGH) 4 .5U ,皮下注射 ,1次 /晚。治疗前后监测血浆前白蛋白、转铁蛋白 ,2 4h尿尿素氮(UN) ,记录体重、肱三头肌皮褶厚度 (TSH)、褥疮病人创面愈合的时间。 结果 :试验组应用rhGH后各项营养指标有较明显增高 ,2 4h尿UN较前减少 ,褥疮创面愈合加快。 结论 :生长激素对慢性消耗性疾病具有改善氮平衡 。

Objectives:To observe the effect of rhGH in the treatment of chronic wasting diseases. Methods:Twenty two cases of chronic wasting diseases needing nutrition support were chosen,including 10 cases of COPD,12 cases of cerebral infarction or cerebral hemorrhage with decubital ulcer in recovery phase.They were in the age of 60～75,in combination with morderate malnutrition.These patients were divided into control group and experimental group.In the experimental group,rhGH(4.5 U/d) was given hypodermically for 10 days.Serum albumin,prealbumin,transferin,24 h urea nitrogen in urine,the surface area of decubital ulcer and mental state were monitored before and after the treatment. Results:In the experimental group,many nutritional indices were increased markedly,24 h urea nitrogen excretion was decreased,the healing of decubitus was faster and mental state was better when compared with control group. Conclusions:The rhGH plays an important role in improving the nutritional status and mental state in patients with chronic wasting diseases. On the base of supplying enough nutrients, rhGH can promote anabolism,reduce the excretion of urea nitrogen in urine, accelerate the healing of decubital ulcer and improve the prognosis.