危重患者术后血浆蛋白和免疫功能的变化及重组人生长激素的治疗作用

目的 观察外科危重患者术后血浆蛋白和免疫功能变化及重组人生长激素（rhGH）的治疗作用。方法 将45例外科危重患者术后随机分为对照组30例和rhGH组15例。两组患者术后治病和营养支持方案相同。rhGH组术后48h开始加用rhGH8U／d肌注，连续7d。观察两组患者血浆蛋白浓度、细胞免疫、体液免疫功能变化及临床结果。结果 两组患者术后血清转铁蛋白、前白蛋白、白蛋白水平；CD3、VD4、VD8、NK活性及CD4／CD8比值均用于正常。rhGH组使用rhGH后第4天血清前白蛋白浓度明显高于治疗前和对照组（P＜0．05），使用rhGH后第8天血清转铁蛋白、前白蛋白、白蛋白浓度均显著高于对照组（P＜0．05，P＜0．01，P＜0．05），CD4、NK活性及CD4／CD8比值均明显高于对照组（P＜0．05，P＜0．01，P＜0．05）。结论 术后营养支持加rhGH迅速改善外科危重患者的营养状况和免疫功能。

Postoperative changes of serum proteins and immune response in criticalpatients and the effects of recombinant human growth hormone

Objective To investigate the postoperative changes of serum proteins and immune responses in critical patients and the effect of recombinant human growth hormone(rhGH).Method 45 critical patients were divided randomly into rhGH group (15 cases) and control group (30 cases) after operation. Patients in rhGH group were given rhGH 8*!U/d,im for 7 days starting 48 hours post operation. Result The postoperative level of serum transferin,albumin and prealbumin decreased in all patients, and so did the activity of CD 3,CD 4 ,CD 8,NK and the ratio of CD 4/CD 8 .Serum prealbumin level increased significantly in rhGH group at day 4 and after ( P <0 05);The level of serum prealbumin,transferin and albumin increased significantly in rhGH group at day 8 and after( P <0 05, P <0 01, P <0 05), and so did the activity of CD 4,NK and the ratio of CD 4/CD 8 ( P <0 01, P <0 01 , P <0 05).Conclusion The combination of nutrition support with rhGH improves the nutritional status and immume response rapidly in critical surgical patients.