重组人生长激素对慢性阻塞性肺疾病合并呼吸衰竭患者机械通气治疗效果的影响

目的：观察 COPD 合并呼吸衰竭机械通气患者中使用重组人生长激素（ rhGH ）的疗效。方法31例COPD脱机困难患者随机分为rhGH治疗组（ rhGH组）和对照组，所有患者均给予抗生素、祛痰解痉药及糖皮质激素、营养支持治疗，治疗组予以rhGH皮下注射9 u／d，连续7～14 d。观察两组患者治疗前后的血浆白蛋白、前白蛋白、尿素氮、肌酐、谷草转氨酶、每日平均血糖值及淋巴细胞计数、C-反应蛋白、机械通气时间、入住ICU时间等。结果与对照组相比，rhGH组血浆总蛋白、白蛋白、前白蛋白、淋巴细胞水平较治疗前显著升高（P＜0．05），分别为（60．3±12．8）g／L比（55．6±10．7）g／L、（38．5±5．4）g／L比（34．6±3．6）g／L、（2．3±0．2）g／L比（2．0±0．1）g／L、（1．15±0．17）×109／L比（1．02±0．18）×109／L，C反应蛋白明显降低（8.4±3.7）mg／L比（12．5±2．4）mg／L（P＜0．05），血糖值轻度升高（6．9±1．1）mmol／L比（6．5±0．8）mmol／L （P＜0．05），机械通气时间缩短（13．2±3．2）d比（16．8±3．7）d、入住ICU时间缩短（17．2±2．5）d比（21．8±2．7）d。结论 COPD合并呼吸衰竭进行机械通气患者应用rhGH治疗可缩短机械通气及入住ICU时间。

The effect of recombinant human growth hormone on mechanical ventilation in COPD patients complicated with respiratory failure

Objective To observe the clinical effect of recombinant human growth hormone on mechanical ventilation in chronic obstructive pulmonary disease （ COPD） patients complicated with respiratory failure .Methods 31 COPD patients complicated with respiratory failure were randomly divided into rhGH treatment group and control group .All the patients were given antibiotics ,expectorants ,bronchodilators ,glucocorticoid and nutritional support ther-apy.The treatment group was given subcutaneous injection of rhGH ,9u/d,7~14d.The plasma-albumin,prealbumin, ureanitrogen,creatinine,GOT,dailyaveragebloodglucose ,lymphocytecount,C-reactiveprotein,tionofmechanical＆nbsp;ventilation,ICU stays were observed pretherapy and post-treatment.Results The plasma total protein,plasma-albu-min,prealbumin,lymphocyte count of the treatment group were significantly higher than those of the control group （P〈0.05）,（60.3 ±12.8）g/L vs （55.6 ±10.7 ）g/L,（38.5 ±5.4）g/L vs （34.6 ±3.6）g/L,（2.3 ±0.2）g/L vs （2.0 ±0.1）g/L,（1.15 ±0.17） ×109/L vs （1.02 ±0.18μ） ×109/L respectively,while C-reactive protein in the treatment group was significantly lower than control group [（8.4 ±3.7）mg/L vs （12.5 ±2.4 ）mg/L]（P〈0.05）, blood glucose in the treatment group was slightly higher than control group （6.9 ±1.1） mmol/L vs （6.5 ±0.8 ） mmol/L（P〈0.05）,the duration of mechanical ventilation and ICU stay time in the treatment group were shorter than those in control group [（13.2 ±3.2）days vs （16.8 ±3.7）days,（17.2 ±2.5）days vs （21.8 ±2.7）days].Conclu-sion Recombinant human growth hormone could help in shortening duration of mechanical ventilation and ICU stays for COPD patients complicated with respiratory failure .