重组人生长激素对老年急性肠梗阻肠黏膜屏障功能、细菌移位及全身炎症反应的影响

Effect of recombinant human growth hormone on intestinal barrier function,bacterial translocation and systemic inflammatory response in elderly patients with acute intestinal obstruction

目的:探讨重组人生长激素对老年急性肠梗阻肠黏膜屏障功能、细菌移位及全身炎症反应的影响.方法:选择2010-03/2015-03湖北医药学院附属襄阳医院肛肠科收治的老年急性肠梗阻行手术治疗患者80例,按照随机数字法分为两组,各40例,对照组实施对症支持处理,观察组在对照组基础上使用重组人生长激素,比较两组干预前后24 h尿99m Tc-DTPA排泄率、两组治疗前后血清内毒素水平、两组治疗后静息能量消耗及非蛋白呼吸商情况及治疗前后两组白介素(interleukin,IL)-6、肿瘤坏死因子-a(tumor necrosis factora,TNF-a)和血栓素B_2(thromboxane B_2,TXB_2)变化情况.结果:治疗后观察组24 h尿99m Tc-DTPA排泄率低于治疗前及治疗后对照组(P<0.05),治疗后观察组血清内毒素水平低于治疗前及治疗后对照组(P<0.05),治疗后观察组静息能量消耗及非蛋白呼吸商水平低于治疗前及治疗后对照组(P<0.05),治疗后观察组IL-6、TNF-a和TXB_2水平低于治疗前及治疗后对照组(P<0.05).结论:对于老年肠梗阻,使用重组人生长激素治疗能有效的恢复肠黏膜屏障功能,减少肠道菌群移位,减轻全身炎症反应.

AIM： To investigate the effect of recombinant human growth hormone on intestinal barrier function, bacterial translocation and systemic inflammatory response in elderly patients with acute intestinal obstruction. METHODS： Eighty elderly patients who underwent surgery for acute intestinal obstruction from March 2010 to March 2015 at our hospital were randomly divided into either an observation group or a control group, with 40 cases in each group. The control group was given symptomatic and supportive treatment, and the observation group was additionally given recombinant human growth hormone on the basis of treatments used in the control group. The 24-h uri13e excretion rate of 99mTc- DTPA, serum endotoxin levels, and serum levels of interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α） and thromboxane B2 （TXB2） before and after treatment, as well as resting energy expenditure and non-protein respiratory quotient after treatment were compared in the two groups. RESULTS： After treatment, the 24-h urinary excretion of 99mTc-DTPA in the observation group was significantly lower than that before treatment and that of the control group after treatment （P 〈 0.05）. Serum toxin level in the observation group after treatment was significantly lower than that before treatmentand that of the control group after treatment （P 〈 0.05）. Resting energy expenditure and non- protein respiratory quotient in the observation group after treatment were significantly lower than those before treatment and those of the control group after treatment （P 〈 0.05）. Serum levels of IL-6, TNF-~ and TXB2 in the observation group were significantly lower than those before treatment and those of the control group after treatment （P 〈 0.05）. CONCLUSION： For elderly patients with acute intestinal obstruction, the use of recombinant human growth hormone can effectively restore the intestinal barrier function and reduce intestinal bacterial translocation and systemic inflammation.