rhGH对烧伤患者垂体-睾丸轴影响的文献对照研究

目的：探讨重组人生长激素（rhGH）治疗对烧伤患者垂体－睾丸轴的影响。方法采用化学发光免疫测定法和竞争性化学发光酶免疫分析法测定9名男性特重度烧伤患者应用rhGH治疗后，在伤后30天内，血清黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）、雌二醇（E2）水平的变化。通过与文献对照，比较rhGH治疗对烧伤患者垂体－睾丸轴的影响。结果文献报道特重度烧伤后患者血清LH、FSH、T水平明显降低，伤后30天，LH升高至正常水平，FSH、T仍未恢复正常水平；E2水平伤后明显增高，而后逐步下降，伤后30天至正常水平。本研究中应用rhGH治疗的特重度烧伤患者血清LH、FSH、T在伤后明显降低与文献一致，在伤后30天，血清LH、FSH已恢复到正常水平，血清T水平有显著的增高，但未达到正常水平。血清E2水平伤后明显升高，在伤后30天已明显下降但尚未降至正常对照组水平。结论特重度烧伤后垂体－睾丸轴功能受到抑制，合理的rhGH应用有利于LH、FSH水平恢复正常，有助于烧伤后垂体功能的恢复。

rhGH effect on burn patients with pituitary-testicular axis with literature study

Objective To investigate the effect of recombinant human growth hormone （rhGH）on pituitary testicular axis in severely burned patients. Methods From April 2010 to June 2011, 9 male patients with over 51% total body surface area （TBSA） or 21% full-thickness burns, were subcutaneously injected with 0.2~0.3U.kg-1.d-1 rhGH from post burn day （PBD）7 to 28. Blood samples were collected in PBD3 and PBD30 to detect the luteinizing hormone （LH）, follicle stimulating hormone （FSH）, testosterone （T）, and estradiol （E2）. Results As the literatures reported, the serum FSH, LH, and T levels significantly decreased after injury （BSA〉51% TBSA） and on the PBD30, the serum LH level reached the normal level, serum FSH, T levels were significantly higher than PBD3 but there were still significant lower than the normal control . The serum E2 level was obviously increased after injury , then returned to normal on the PBD30. With the administration of rhGH, the serum FSH, LH, and T levels on the PBD3 were also significantly lower than those in the normal control group. But on the PBD30, the serum FSH and LH levels reached the normal level, and serum T level was significantly higher than that on the PBD3 （ P〈 0.01）, but there was still significant lower than the normal control group （ P〈0.01）. The serum E2 level on the PBD3 was obviously higher than normal level, and PBD30 had significantly decreased comparing with PBD3 （ P〈0.05）, but not fallen to normal level. Conclusion The activity of pituitary might be restrained after severely burned trauma. Administration of rhGH in patients with major burn could improve pituitary function （FSH and LH levels） recovery.