小剂量重组人生长激素对腹腔脓毒症病人疾病严重度的影响

Effects of low-dose recombinant human growth hormone on severity of illness in patients with abdominal sepsis

目的 :观察腹腔脓毒症病人应用小剂量生长激素 (GH)后疾病严重度的变化 ,评估GH对脓毒症病人病情和预后的影响 ,从而评价GH在脓毒症病人中应用的安全性。 方法 :1 8例非肿瘤、既往无代谢性疾病史的腹腔脓毒症病人 ,在进行外科引流并且血流动力学平稳后进入 8天的研究 ,第 1天为基准阶段 ,其后每天给予重组人生长激素 (rhGH) 1 0U ,肌内注射 ,检测每天的血清GH、IGF 1和IGFBP 3的浓度 ,应用APACHE Ⅱ评分系统和Elebute&Stoner的脓毒症评分系统 ,每天进行疾病严重度的评估。 结果 :应用rhGH后 ,血清GH、IGF 1和IGFBP 3的浓度均有明显升高 ,疾病严重度的评分均有明显下降。 结论 :rhGH在腹腔脓毒症病人中应用可以发挥其生物学效应 ;腹腔脓毒症病人在行病灶清除引流 ,生命体征平稳后应用rhGH是安全的。脓毒症病人的疾病严重度评分并未增加 ,脓毒症评分在用药期间明显减小。

Objectives: To investigate the effects of low dose growth hormone administration on severity of illness, and to evaluate its safety in abdominal sepsis patients. Methods: Eighteen patients with abdominal sepsis were studied for 8 days after they had accepted surgical drainage and achieved a stable hemodynamic status. After a baseline period they received 10 U recombinant human growth hormone each morning for 7 days. Serum concentration of growth hormone, insulin like growth factor 1 and its binding protein (IGFBP 3) were measured before and 1 st , 3 rd , 5 th and 7 th days after GH administration. The severity of illness was assessed everyday with the Acute Physiology and Chronic Health Evaluation(APACHE) Ⅱscoring system and the Elebute & Stoner's sepsis score system. Results: The serum concentration of GH, IGF 1, IGFBP 3 increased significantly after growth hormone administration. The severity of illness had been improved since the third day after GH administration. Side effects other than hyperglycemia were not observed. Conclusions: Low dose growth hormone administration in abdominal sepsis patients resulted in improvementof severity of illness.