重组人生长激素在梗阻性黄疸的临床应用

目的　观察重组人生长激素 (rhGH)应用于梗阻性黄疸术后的治疗作用。方法　将 48例患者随机分为对照组 3 0例和rhGH组 18例 ,从术后第 1天开始 ,rhGH组皮下注射rhGH ,8U/d ,连续 7d ,与此同时对照组注射相同剂量的生理盐水。两组患者都给予肠道外营养支持治疗到能进食、水为止。并分别于术前、术后 1d、7d及 14d测定患者的生化全套、内毒素、肿瘤坏死因子及可溶性白细胞介素 2受体水平 ,并观察患者营养状况的改变。结果　术后 4drhGH组体重开始增加 ,术后 7d ,对照组体重也开始增加 ,但rhGH组比对照组体重增加明显。术后 7d ,rhGH组比对照组血糖升高 (P<0 .0 5 )。术后 7d ,rhGH组的血清白蛋白、转铁蛋白、前白蛋白比对照组升高 (P<0 .0 5 ) ;总胆汁酸、血清总胆固醇及低密度脂蛋白、血清谷草转氨酶、γ 谷氨酰转移酶、总胆红素、内毒素、肿瘤坏死因子及可溶性白细胞介素 2受体水平比对照组明显降低 (P<0 .0 1)。肾功能以及电解质两组变化无明显差异。结论　rhGH应用于梗阻性黄疸术后能改善机体的营养状况以及免疫功能。

Clinical Application of Recombinant Human Growth Hormone on Obstructive Jaundice

Objective To observe therapeutical effect of recombinant human growth hormone (rhGH) on postoperative obstructive jaundice. Methods Fourty-eight patients were divided into two groups randomly: control group with 30 patients and rhGH group with 18 patients. After operation, subcutaneous injection of rhGH was administered 8 U/d for a week. At the same time, parenteral nutrition was given to both groups until the patients could eat and drink. Biochemistry examination, endotoxin, tumor necrosis factor, sIL-2R and nutritional status were all measured at following states: before operation 1, 7 and 14 days after operation. Results Body weights of rhGH group on the fourth day after operation and that of control group on the seventh day after operation increased, but the increasing tendency of rhGH group was more prominent than the control group. For blood sugar 7 days after operation, the level of rhGH group was higher than that of control group ( P < 0.05). The level of serum albumin, transferrin, prealbumin in rhGH group was higher than that of control goup ( P < 0.05). Blood serum total bile acid,total cholesterol, low density lipoprotein,glutamic- oxal acetic transaminase, transglutaminase, total bilirubin, endotoxin, tumor necrosis factor and sIL-2R were all decreased compared with control group ( P < 0.01). However, no significant difference was observed in renal function and electrolute between the two groups. Conclusion An improvement of nutrition status and immunologic function can be observed in obstructive jaundice patients after the postoperative administration of rhGH.