大面积烧伤病人应用重组人生长激素后血糖变化及其机制的初步探讨  

The effect of recombinant human growth hormone on blood glucose in patients with severe burns

作　　者：郝岱峰[1] 柴家科[1] 申传安[1] 贺立新[1] 郭振荣[1] 盛志勇[1] 

机构地区：[1]解放军第304医院烧伤研究所临床部,北京100037

出　　处：《感染．炎症．修复》2001年第2期98-100,共3页Infection Inflammation Repair

摘　　要：目的:探讨重组人生长激素(rhGH)对大面积烧伤病人血糖的影响及其可能机制。方法:选择1999年1月至2000年5月间,33例烧伤总面积大于30%,Ⅲ°面积大于10%,年龄12～50岁的重度烧伤患者,随机分为rhGH治疗组(rhGH组)和对照组,伤后3天内手术切痂植皮,rhGH组从术后第1天开始每天晚21时按0.2IU/kg皮下注射rhGH共10天,动态观察手术前后不同时间点的血糖、血胰岛素、抗胰岛素抗体、生长激素及胰高血糖素水平的变化。结果:rhGH组术后血糖、血胰岛素、生长激素水平明显高于对照组,抗胰岛素抗体和胰高血糖素增高不明显。结论:烧伤后应用rhGH可导致明显的高血糖和高胰岛素血症,原因可能为rhGH本身对物质代谢的作用和胰岛素抵抗,而胰岛素抵抗的发生并非由于抗胰岛素抗体过度产生所致。Objective: To determine the effect of recombinant human growth hormone (rhGH) on blood glucose in patients with severe burns and the mechanism thereof. Methods: Thirty-three patients, who were 12 to 50 years old with burns over 30% of the total body surface area (TBSA) and third-degree burns over 10% TBSA were admitted to our center from January, 1999 to May, 2000. They were randomly divided into rhGH treatment group and control group. Both groups were treated with escharectomy and grafting within three days postburn. The patiens of the rhGH treatment group wee given rhGH 0.2 IU/kg hypodermically at 21h every night for ten days started from the first postoperation day. The changes in plasma concentration of glucose, insulin, anti-insulin antibody, growth hormone and glucagon were observed dynamically at different time points before and after surgical intervention. Results: It was shown that after the surgical intervention plasma concentrations of glucose, insulin and growth hormone in the rhGH treatment group were obviously higher compared with the control group, while the increase in anti-insulin antibody and glucagon was not obvious. Conclusion: The use of rhGH postburn can lead to remarkable hyperglycemia and hyperinsulinemia, and its possible cause may be the result of the effect of rhGH on the regulation of metabolism and insulin-resistance. However the occurrence of insulin-resistance is not caused by the overproduction of anti-insulin antibody.

关 键 词：烧伤 重组人生长激素 高血糖 

分 类 号：R64[医药卫生—外科学]