【摘要】 目的 探讨严重腹腔感染合并呼吸循环功能障碍的有效治疗方法。方法 选择2004 年10 月至2006 年5 月期间我院ICU 收治的严重腹腔感染合并呼吸循环功能障碍患者42 例,其中治疗组( n = 22) 应用乌司他丁和生长激素联合治疗方案,对照组( n = 20) 应用常规治疗。比较2 组病例的临床病死率,并对2 组病例的ICU 住院时间及呼吸支持时间、循环支持时间的差异进行分析。结果 治疗组与对照组的临床病死率(22. 7 % vs35. 0 %) 差异无统计学意义( Pgt; 0. 05) ,而治疗组较对照组ICU 住院时间〔(12. 1 ±4. 2) d vs (18. 8 ±3. 6) d〕、呼吸支持时间〔(10. 1 ±3. 1) d vs (15. 4 ±4. 4) d〕及循环支持时间〔(5. 6 ±1. 8) d vs (11. 3 ±2. 1) d〕明显减少( P lt;0. 05) 。结论 乌司他丁和生长激素联合使用可以改善严重腹腔感染合并呼吸循环功能障碍的治疗效果。
Objective To explore the effects of recombinant human growth hormone （rhGH） on senile patients after pancreaticoduodenectomy. MethodsFortysix patients were divided into the therapeutic group (rhGH, n=17) and control group (n=29). Both were treated with parenteral nutrition. In the therapeutic group, rhGH (8 u/d) was given hypodermically for 7 days. After operation the levels of albumin, prealbumin, transferrin, and immunoglobulin were measured. Postoperative fatigue syndrome and the average length of stay in hospital were observed too. ResultsAfter operation the levels of albumin, prealbumin, transferrin, and immunoglobulin in the therapeutic group were significantly higher than those of control group. The degree of postoperative fatigue syndrome in the therapeutic group was less than that of control group. The average length of stay in hospital was significantly shortened. Conclusion The early application of rhGH in senile patients after pancreaticoduodenectomy can enhance immune function, reduce the incidence of infection, promote the postoperative recovery, shorten the average length of stay in hospital,decrease the mortality, increase the safety of operation and improve the postoperative life quality of senile patients.
ObjectiveTherapeutical effect of recombinant human growth hormone （rhGH) on obstructive jaundice and internal and external drainage was observed.MethodsNew Zealand white rabbits were randomly divided into groups below: obstructive jaundice internal drainage plus rhGH group, obstructive jaundice internal drainage plus NS group, obstructive jaundice external drainage plus NS group, and obstructive jaundice external drainage plus rhGH group. After the establishment of obstructive jaundice model, rhGH was used in the above groups. Subcutaneous injection of rhGH 0.2 IU/kg was given twice a day. Isovolume NS was used on the control groups. Full set of endotoxin, tumor necrosis factor, sIL2R and nutritional status were estimated before the model establishment, and 14 days after the model established, 14 days after internal and external drainage.ResultsFour days after internal and external drainage, body weight of therapy groups was increased compared with control groups (P＜0.05). Seven days and ten days after obstructive jaundice, blood sugar of therapy groups rised compared with control groups (P＜0.05). Albuminate, siderophilin and prealbumin of therapy groups were all observed an increase after 14 days after obstructive jaundice, and 14 days after internal and external drainage (P＜0.01). Blood total cholesterol, low density lipoprotein and omni bile acid of therapy groups after 14 days of obstructive jaundice were increased apparently (P＜0.05). Blood glutamicoxal acetic transaminase, transglutaminase, total bilirubin, blood uria nitrogen, creatinine and uric acid of therapy group after 14 obstructive jaundice days were increased (P＜0.05). Ca2+ of therapy groups 14 days after obstructive jaundice, 14 days after internal and external drainage rised as compared with control groups (P＜0.05). However, K+,Na+ of therapy groups 14 days after external drainage decreased (P＜0.05). An increasing tendency of sIL2R was observed in control groups 14 days after obstructive jaundice(P＜0.05) and ET,αTNF,sIL2R of control groups was decreased 14 days after internal and external drainage (P＜0.01).ConclusionAfter rhGH is used in obstructive jaundice and internal and external drainage, an improvement of nutritional status and immunological function can be observed.
OBJECTIVE: To investigate the effect of combined treatment of recombinant human growth hormone (rhGH) and insulin-like growth factor-1 (IGF-1) on wound healing and protein catabolism in burned rats. METHODS: Forty Wistar rats with deep II degree scald injury were divided randomly into four groups and received rhGH (0.1 U/kg.d), rhGH (0.1 U/kg.d) plus IGF-1 (2.0 mg/kg.d), IGF-1 (2.0 mg/kg.d) and Ringer’s solution (2 ml/kg.d, as control group) respectively. The wound healing time and protein catabolism levels of every groups were compared after 2 weeks. RESULTS: Total body weight began to increase after 2 weeks in rhGH group and rhGH plus IGF-1 group, but in control group, it was occurred after 4-5 weeks. The body weight of rhGH plus IGF-1 group was 1.65 times than that of rhGH group. The wound healing time in rhGH plus IGF-1 group (17.1 +/- 4.4) days was significantly lower than that of rhGH (20.5 +/- 4.8) days and control group (29.7 +/- 6.3) days. The protein level of rhGH plus IGF-1 group was significantly higher than that of control group and rhGH group. CONCLUSION: It suggests that rhGH plus IGF-1 with synergism is more effective in promoting wound healing and increasing the protein catabolism.
ObjectiveTo investigate whether the recombinant human growth hormone (rhGH) can promote endothelialization, inhibit vascular intimal hyperplasia, and improve long-term patency rate by the treatment of rhGH after vascular prostheses bypass. MethodsBetween August 2007 and January 2009, 94 patients with lower extremity arteriosclerotic occlusive disease were treated. Among them, 32 patients (34 limbs) who met the selection criteria were enrolled in this study. All cases were randomly divided into study group (16 cases, 18 limbs) and control group (16 cases, 16 limbs). There was no significant difference (P>0.05) in gender, age, disease time, location of lesions, the Trans-Atlantic Inter-Society Consensus (TASC) grade, and basic diseases between 2 groups. The patients with superficial femoral artery disease received above-knee femoro-popliteal prostheses bypass. The patients who had combined abdominal-iliac artery disease received concurrent abdominal-femoral and femoro-popliteal prostheses bypass. Subcutaneous injection of 9 U rhGH was given every night for 7 days in study group, and saline was applied in control group. Ultrasonography was taken after 2 weeks and 3 months of operation to observe the patency and measure the wall thickness of vascular prostheses. ResultsAfter operation, 1 patient of control group died of renal failure caused by acute thrombosis. After 2 weeks, ultrasonography showed no obvious intimal hyperplasia in 2 groups; the wall thickness was (0.13±0.02) cm in study group and (0.15±0.03) cm in control group, showing no significant difference (t=-1.720, P=0.108). After 3 months, the wall thickness was (0.17±0.06) cm in study group and was (0.26±0.09) cm in control group, showing significant difference (t=-2.240, P=0.045). All cases were followed up 36-60 months (mean, 56.4 months). The 5-year primary patency rate was 52.5% in study group and 35.7% in control group, showing no significant difference (χ2=1.470, P=0.225). ConclusionThe rhGH can improve endothelialization in vascular prostheses and can inhibit postoperative vascular intimal hyperplasia in clinical application.
ObjectiveTo explore whether the growth hormone receptor (GHR) is present in human hepatocellular carcinoma (HCC). MethodsThe GHR were measured in samples of human HCC (50 cases), the liver tissues adjacent to hepatocellular carcinoma (49 cases), cirrhotic liver tissues (30 cases) and control liver tissues (30 cases) by immunohistochemistry technique. ResultsThe GHR positive expression rate was 42.0% in samples of human hepatocellular carcinoma, and 95.9% in adjacent tissue of HCC, 96.7% in cirrhotic liver tissues, and 93.3% in normal liver tissues; the significance of the differences in the GHR positive expression rate was seen between HCC and the compared groups.ConclusionThe lower expression of GHR in HCC is present. The growth hormone administration can be used in patients of HCC with radical resection or GHR negative expression patient.
【Abstract】ObjectiveTo prospectively study the effects of recombinant human growth hormone (rhGH) on the changes of liver function and nutritional metabolism in postoperative patients with cirrhosis and portal hypertension. MethodsFortyeight cases with liver cirrhosis and portal hypertension who were collected from February 2003 to January 2004 were randomly divided into 2 groups (24 patients in each group). All patients were given the low calorie parenteral nutrition support and exogenous albumen after operations. Patients in the study group received rhGH from the second day after operations and physiological saline was used in the control group instead. The effects were evaluated in terms of protein metabolism, liver function, blood glucose level at different phases before and after the intervene. Death rates of in patients were also recorded in both groups. ResultsThe rising amplitude of albumen in the study group had been significantly larger than that of the control group from the seventh day after intervene (P＜0.05). The blood transaminase levels (ALT，AST) in the study group were significantly lower than that of the control group (P＜0.05). The blood glucose level of both groups decreased over time and returned to normal on day 14 after intervene, but there was no significant difference for both glucose and plasma bilirubin level between the two groups before and after the intervene (Pgt;0.05). The rates of death were similar, although the length of stay in the study group was much shorter than that of the control group. ConclusionrhGH may inhibit the catabolism, correct hypoproteinemia, improve liver function for postoperative patients with cirrhosis and portal hypertension, and reduce their length of stay.
Objective To assess the effectiveness and the safety of clinical use of growth hormone (GH) in burn patients. Method Search were applied to the following electronic databases: Chinese Bio-medicine Database (CBM), MEDLINE, EMBASE and Cochrane Library. Language was restricted in Chinese and English. Data were extracted and evaluated by the two reviewers independently of each other. Applied RevMan 4.1 for statistical analyse. Results Nine trials involving 732 patients were included. The combined results showed that GH can shorten wound healing time [weighted mean difference (WMD) = -11.25, 95%CI (-14.84 to -7.66), Plt;0.000 01], donor site healing times [WMD= -1.87, 95%CI (-2.28 to -1.47), P＜0.000 01), and length of hospital stay [WMD= -8.10, 95%CI (-10.40 to -5.79), P＜0.000 01]. There was no statistical significance on resting energy expenditure [WMD= -0.04, 95%CI ( -0.08 to 0.00), P=0.06], mortality [odds ratio (OR) =1.15, 95%CI (0.15 to 8.53), P=0.9], sepsis [OR=1.08, 95%CI (0.50 to 2.34), P=0.8] and ventilatory support required [OR=1.51, 95%CI (0.72 to 3.16), P=0.3]. Nevertheless, the plasma levels of glucose [standardized mean difference (SMD) =0.98, 95%CI (0.54 to1.42), P＜0.000 01] and insulin [SMD=0.86, 95%CI (0.43 to1.30), P=0.000 1] were increased in GH groups. Conclusions GH for burn patients is effective and safe if blood glucose can be controlled well.
【Abstract】Objective To investigate the effects of human growth hormone (GH) on colonic cancer cells to provide experimental evidence about the GH safety in colonic cancer therapy. Methods The nude mouse model of colonic carcinoma induced with SW480 cell line was established to observe the effects of GH on the transplanted carcinoma. GH and 5-FU were administered to SW480 cells cultured in vitro to observe the cell growth with MTT method. Results The volume, average diameter and weight of the transplanted carcinoma in GH group were significantly higher than those in control group（P＜0.05）. In vitro, the value of A in GH group was significantly higher than control group （P＜0.01), but the value of A in 5-FU+GH group was lower than control group（P＜0.01）. Conclusion GH can promote colonic cancer cell growth; GH combined with cell cycle specific chemotherapeutic drugs is safe in colonic cancer therapy and may be used as a promoter of chemotherapy.