重组人生长激素治疗肝炎后肝硬化患者低蛋白血症的实验与临床研究

目的评价重组人生长激素对肝炎后肝硬化患者低蛋白血症的影响.方法治疗组31例肝硬化患者用重组人生长激素(每日0.25 IU/kg)、对照组20例用人血白蛋白(10 g/d)治疗10 d,用放射免疫法测定治疗前、后24 h及治疗结束时的血清生长激素(GH)、类胰岛素生长因子(IGF)-1、白蛋白(ALB)水平,另以同样方法测定10例健康人的GH、IGF-1水平.结果肝硬化患者治疗前的GH水平高于健康人(4.96±3.97,1.62±2.26,P<0.05),而IGF-1水平明显低于健康人(36.53±12.77,56.95±10.46,P<0.01).经重组人生长激素治疗后,IGF-1和ALB明显增高,与对照组比较差异有显著性(P<0.01).结论重组人生长激素可以克服肝硬化患者的生长激素抵抗现象;对其低蛋白血症的改善优于单纯人血白蛋白治疗.

Experimental and clinical studies of recombinant human growth hormone treatement of hypoproteinemia of liver cirrhosis patients

BACKGROUND: To assess the effect of recombinant human growth hormone (rhGH) therapy to liver cirrhosis patients with hypoproteinemia. METHODS: 31 liver cirrhosis patients were treated with rh GH (0.25 IU/kg/day-) and 20 such patients with human albumin (10 g/day) as control all for 10 days. Serum levels of growth hormone (GH), insulin-like growth factor (IGF)-1 and albumin (ALB) were measured by radio-immunoassay before 24h and after 24h and 10 days of rhGH therapy.Serum levels of GH and IGF-1 of 10 age matched healthy subjects were also measured. RESULTS: As compared with healthy subjects, the pretreatment serum GH level of liver cirrhosis patients was high (4.96 +/- 3.97 vs 1.62 +/- 2.26, P <0.05), and the IGF-1 level was markedly lower (36.53 +/- 12.77 vs 56.95 +/- 16.46, P <0.01). After 10 days of rhGH administration, the serum IGF-1 and ALB levels of the treated group increased significantly as compared with the control group (P <0.01). CONCLUSIONS: Exogenous rhGH therapy can overcome the GH resistance of liver cirrhosis patient s and can increase significantly the serum albumin level as compared with the control group who were treated with human albumin only.