生长激素强化肠内营养对术后蛋白质代谢的影响

目的 :　了解重组人生长激素 (GH)强化低能量肠内营养 (EN)对心脏手术后病人蛋白质代谢的影响。方法 :　对 3 6例心脏手术后病人随机分成 GH强化 EN治疗组 (试验组 )与单纯EN治疗组 (对照组 )。治疗在术后持续 7天。检测术前、术后第 1、4、8d血浆白蛋白 (A)、转铁蛋白(TF)、前白蛋白 (PA)、视黄醇结合蛋白 (RBP)及术后第 1、2、3、5、7d的氮平衡 (NB) ,并进行组内及组间比较。结果 :　术前两组病人血浆 A、TF、PA、RBP水平无显著差异。术后第 1 d两组病人血浆 A、TF、PA、RBP均较低 ,仅 RBP试验组高于对照组 ;术后第 4、8d血浆 TF、PA、RBP试验组明显高于对照组 ,术后第 8d血浆 A试验组明显高于对照组 ,及术后第 1、2、3、5、7d NB改善试验组明显好于对照组。结论 :　心脏手术后使用重组人 GH强化 EN能在较短时间内提高血浆 A、TF、PA、RBP的水平 ,纠正病人负 NB,改善病人营养状况

EFFECT OF GROWTH HORMONE AND ENTERAL NUTRITION ON PROTEIN METABOLISM IN PATIENTS AFTER CARDIAC OPERATIONS

Objective: To investigate the effect of growth hormone(GH) and hypo calorie enteral nutrition(EN) on protein metabolism in patients after cardiac operations. Methods: 36 patients after cardiac operations were randomly divided into two groups. The test group received GH and EN, and the control group received EN only. The treatment was maintained 7 days postoperatively. Plasma albumin(A)?transferrin(TF)?prealbumin (PA)?retinol binding protein(RBP) on the preoperative day and day 1,4,8 postoperatively and nitrogen balance(NB) on the day 1,2,3,5,7 postoperatively were detected. Results: There was no significant difference of all plasma protein levels between two groups before operation and all decreased on the 1st postoperative day, but only RBP higher in the test group than that in the control. There was significant difference in TF,PA,RBP levels on the 4th and 8th postoperative day, the plasma A level on the 8th postoperative day, and NB on the 1st to 7th postoperative day between the two groups. Conclusion: Combined use of GH and EN can elevate plasma A,TF,PA,RBP levels and improve negative NB.