Objective To explore the impact of recombinant human growth hormone (rhGH) on T lymphocyte subsets in patients with rheumatic heart disease during the perioperative period of heart valve replacement. Methods A total of 65 patients with rheumatic valvular heart disease who received heart valve replacement in Department of Cardiothoracic Surgery of Xiangyang Central Hospital from June 1, 2011 to March 31, 2012 were enrolled in this double-blind randomized controlled clinical study. All the patients were divided into 2 groups by random number produced by SAS software:the trial group and the control group. There were 35 patients in the trial group including 19 males and 16 females with their average age of 50.57 years, and 30 patients in the control group including 16 males and 14 females with their average age of 49.87 years. Apart from routine cardiac glycosides, diuretics, glucose-insulin-potassium solution, and postoperative anti-infective therapy, patients in the trial group also received subcutaneously injection of rhGH 5 U (1 ml)daily from 1 day before surgery to 3 days after surgery, and patients in the control group received subcutaneously injection of normal saline 1 ml as placebo. Peripheral venous blood samples were taken in the morning 2 days before surgery and 1 st, 3 rd, 7 th day after surgery respectively. Percentages of CD3+, CD4+, CD8+ were examined timely by flow cytometry and CD4+ /CD8+ ratio was calculated. Results In the control group, percentages of CD3+, CD4+ and CD4+ /CD8+ ratio on the 1st, 3rd, 7th postoperative day were significantly lower than preoperative levels, and percentages of CD8+ on the 1st and 3rd postoperative day were significantly lower than preoperative level (P<0.05). In the trial group, percentages of CD3+, CD4+, and CD8+ on the 1st and 3rd postoperative day were significantly lower than preoperative levels(P<0.05), while percentages of CD3+, CD4+, and CD8+ on the 7th postoperative day were not statistically different from preoperative levels (P>0.05); CD4+ /CD8+ ratio on the 1st postoperative day was significantly lower than preoperative level (P<0.05), while CD4+ /CD8+ ratios on the 3rd and 7th postoperative day were not statistically different from preoperative level (P>0.05). There was no statistical difference in preoperative T lymphocyte subsets between the trial group and the control group (P>0.05). The percentages of CD4+ and CD4+/CD8+ ratio in the trial group were significantly higher than those of the control group on the 1st postoperative day (P<0.05), while the percentages of CD3+ and CD4+ and CD4+ /CD8+ratio in the trial group were significantly higher than those of the control group on the 3rd and 7th postoperative day(P<0.05). Conclusion Use of rhGH can significantly increase T lymphocyte subsets expression, enhance body cellular immunity, and improve postoperative recovery of patients with rheumatic valvular heart disease during the perioperative period of heart valve replacement.
Citation:
LIU Rihui,LIU Shan,NIE Ronghua,CHEN Jiajun,HUANG Chunrong.. Impact of Recombinant Human Growth Hormone on T Lymphocyte Subsets in Perioperative Patients with Rheumatic Heart Disease: A Randomized Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(3): 284-287. doi: 10.7507/1007-4848.20130088
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袁媛, 王峰, 赵欣, 等. 重组人生长激素干预消化道肿瘤患者术后蛋白质代谢Meta分析. 肿瘤学杂志, 2011, 17 (6):412-415.
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高雯, 季英敏, 张剑. 风心病的免疫功能. 实用心电学杂志, 2004, 13 (5):362-364.
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Kvakan H, Kleinewietfeld M, Qadri F, et al. Regulatory T cells ameliorate angiotensinⅡ-induced cardiac damage. Circulation, 2009, 119 (22):2904-2912.
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姚恒臣, 李复领, 赵宗进, 等. 心力衰竭患者T淋巴细胞亚群和自然杀伤细胞活性的变化. 中华心血管病杂志, 2006, 34 (9):851.
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王淑华, 张子强. 免疫调节与慢性心力衰竭相关研究. 中国煤炭工业医学杂志, 2011, 14 (1):17-19.
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王欢, 王欣, 谢维泉, 等. 风湿性心脏病新瓣膜置换患者术前免疫功能的变化. 中国胸心血管外科临床杂志, 2000, 7 (2):77-79.
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倪海峰, 肖颖彬. 体外循环对T淋巴细胞细胞免疫功能的影响. 中国胸心血管外科临床杂志, 2008, 15 (2):104-107.
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郭宏伟, 于建华, 刘美明, 等. 心脏瓣膜置换术后机体免疫功能的变化. 山东医药, 2009, 49 (18):15-17.
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郭巍, 邹承伟, 王安彪, 等. 西咪替丁对体外循环手术患者免疫功能的保护作用. 中国胸心血管外科临床杂志, 2007, 14 (2):97-100.
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包建华. 重组人生长激素的临床应用进展. 药学服务与研究, 2008, 8 (4):272-275.
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11. |
Jeay S, Sonenshein GE, Postel-Vinay MC, et al. Growth hormone can act as a cytokine controlling survival and proliferation of immune cells:new insights into signaling pathways. Mol Cell Endocrinol, 2002, 188 (1-2):1-7.
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王辉, 邓洁英, 史轶蘩. 生长激素调节T淋巴细胞的功能. 中国免疫学杂志, 2000, 16 (9):480-484.
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13. |
郄文斌, 屠伟峰, 彭捷, 等. rhGH对肠道缺血再灌注损伤大鼠促炎介质介导性肺损伤的影响. 实用医学杂志, 2011, 27 (20):3643-3645.
|
14. |
徐一洲, 黄煌, 曹玥, 等. 重组人生长激素对败血症大鼠炎症调控网络的影响. 华西药学杂志, 2007, 22 (2):142-144.
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15. |
Cittadini A, Grossman JD, Napoli R, et al. Growth hormone attenuatesearly left ventricular remodeling and improves cardiac function in rats with large myocardial infarction. J Am Coll Cardiol, 1997, 29 (5):1109-1116.
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Tang ZF, Ling YB, Lin N, et al. Glutamine and recombinanthuman growth hormone protect intestinal barrier function following portal hypertension surgery. World J Gastroenterol, 2007, 13 (15):2223-2228.
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Andersen O, Hansen BR, Troensegaard W, et al. Sustained low-dose growth hormone therapy optimizes bioactive insulin-like growth factor-I level and May enhance CD4 T-cell number in HIV infection. J Med Virol, 2010, 82 (2):197-205.
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18. |
孟毅, 董逸飞, 董书强, 等. 心脏瓣膜手术后呼吸衰竭相关危险因素分析. 中国胸心血管外科临床杂志, 2012, 19 (2):168-171.
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Bartolo Z, Gatti G, Rauber E, et al. Early and late outcomes of cardiacsurgery in octogenarians. Ann Thorac Surg, 2009, 87 (1):71-78.
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Rahmanian PB, Adams DH, Castillo JG, et al. Predicting hospital mortality and analysis of long-term survival after major noncardiac complications in cardiac surgery patients. Ann Thorac Surg, 2010, 90 (4):1221-1229.
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王伟, 吴蔚, 何萍, 等. 风湿性心脏病合并恶病质患者术后应用重组人生长激素的临床观察. 中华内分泌外科杂志, 2009, 3 (2):116-119.
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22. |
毛争春, 陈如坤, 赵琳. 重组人生长激素对心脏手术后疲劳综合征的影响. 中华医学杂志, 2002, 82 (11):762-765.
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盛春风, 刘培, 王福珍, 等. 重组人生长激素治疗老年胸腹部手术后急性呼吸衰竭机械通气患者的临床观察. 微循环学杂志, 2012, 22 (1):37-39.
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24. |
安小虎, 张磊, 朱颖霞. 重组人生长激素治疗术后呼吸衰竭的临床效果. 同济大学学报:医学版, 2008, 29 (2):62-64, 68.
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- 1. 袁媛, 王峰, 赵欣, 等. 重组人生长激素干预消化道肿瘤患者术后蛋白质代谢Meta分析. 肿瘤学杂志, 2011, 17 (6):412-415.
- 2. 高雯, 季英敏, 张剑. 风心病的免疫功能. 实用心电学杂志, 2004, 13 (5):362-364.
- 3. Kvakan H, Kleinewietfeld M, Qadri F, et al. Regulatory T cells ameliorate angiotensinⅡ-induced cardiac damage. Circulation, 2009, 119 (22):2904-2912.
- 4. 姚恒臣, 李复领, 赵宗进, 等. 心力衰竭患者T淋巴细胞亚群和自然杀伤细胞活性的变化. 中华心血管病杂志, 2006, 34 (9):851.
- 5. 王淑华, 张子强. 免疫调节与慢性心力衰竭相关研究. 中国煤炭工业医学杂志, 2011, 14 (1):17-19.
- 6. 王欢, 王欣, 谢维泉, 等. 风湿性心脏病新瓣膜置换患者术前免疫功能的变化. 中国胸心血管外科临床杂志, 2000, 7 (2):77-79.
- 7. 倪海峰, 肖颖彬. 体外循环对T淋巴细胞细胞免疫功能的影响. 中国胸心血管外科临床杂志, 2008, 15 (2):104-107.
- 8. 郭宏伟, 于建华, 刘美明, 等. 心脏瓣膜置换术后机体免疫功能的变化. 山东医药, 2009, 49 (18):15-17.
- 9. 郭巍, 邹承伟, 王安彪, 等. 西咪替丁对体外循环手术患者免疫功能的保护作用. 中国胸心血管外科临床杂志, 2007, 14 (2):97-100.
- 10. 包建华. 重组人生长激素的临床应用进展. 药学服务与研究, 2008, 8 (4):272-275.
- 11. Jeay S, Sonenshein GE, Postel-Vinay MC, et al. Growth hormone can act as a cytokine controlling survival and proliferation of immune cells:new insights into signaling pathways. Mol Cell Endocrinol, 2002, 188 (1-2):1-7.
- 12. 王辉, 邓洁英, 史轶蘩. 生长激素调节T淋巴细胞的功能. 中国免疫学杂志, 2000, 16 (9):480-484.
- 13. 郄文斌, 屠伟峰, 彭捷, 等. rhGH对肠道缺血再灌注损伤大鼠促炎介质介导性肺损伤的影响. 实用医学杂志, 2011, 27 (20):3643-3645.
- 14. 徐一洲, 黄煌, 曹玥, 等. 重组人生长激素对败血症大鼠炎症调控网络的影响. 华西药学杂志, 2007, 22 (2):142-144.
- 15. Cittadini A, Grossman JD, Napoli R, et al. Growth hormone attenuatesearly left ventricular remodeling and improves cardiac function in rats with large myocardial infarction. J Am Coll Cardiol, 1997, 29 (5):1109-1116.
- 16. Tang ZF, Ling YB, Lin N, et al. Glutamine and recombinanthuman growth hormone protect intestinal barrier function following portal hypertension surgery. World J Gastroenterol, 2007, 13 (15):2223-2228.
- 17. Andersen O, Hansen BR, Troensegaard W, et al. Sustained low-dose growth hormone therapy optimizes bioactive insulin-like growth factor-I level and May enhance CD4 T-cell number in HIV infection. J Med Virol, 2010, 82 (2):197-205.
- 18. 孟毅, 董逸飞, 董书强, 等. 心脏瓣膜手术后呼吸衰竭相关危险因素分析. 中国胸心血管外科临床杂志, 2012, 19 (2):168-171.
- 19. Bartolo Z, Gatti G, Rauber E, et al. Early and late outcomes of cardiacsurgery in octogenarians. Ann Thorac Surg, 2009, 87 (1):71-78.
- 20. Rahmanian PB, Adams DH, Castillo JG, et al. Predicting hospital mortality and analysis of long-term survival after major noncardiac complications in cardiac surgery patients. Ann Thorac Surg, 2010, 90 (4):1221-1229.
- 21. 王伟, 吴蔚, 何萍, 等. 风湿性心脏病合并恶病质患者术后应用重组人生长激素的临床观察. 中华内分泌外科杂志, 2009, 3 (2):116-119.
- 22. 毛争春, 陈如坤, 赵琳. 重组人生长激素对心脏手术后疲劳综合征的影响. 中华医学杂志, 2002, 82 (11):762-765.
- 23. 盛春风, 刘培, 王福珍, 等. 重组人生长激素治疗老年胸腹部手术后急性呼吸衰竭机械通气患者的临床观察. 微循环学杂志, 2012, 22 (1):37-39.
- 24. 安小虎, 张磊, 朱颖霞. 重组人生长激素治疗术后呼吸衰竭的临床效果. 同济大学学报:医学版, 2008, 29 (2):62-64, 68.