重组人生长激素对慢性重型病毒性肝炎生长激素-胰岛素样生长因子轴的影响  

Effects of recombined human growth hormone on growth hormone and insulin-like growth factor axes in patients with chronic severe viral hepatitis

作　　者：张斌[1] 丁惠国[1] 董培玲[1] 范春蕾[1] 周莉[1] 林伟[1] 罗晓岚[1] 金瑞[1] 赵春惠[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝病消化科,北京100054

出　　处：《临床荟萃》2005年第22期1261-1263,共3页Clinical Focus

基　　金：北京市科委项目(H010210110129);中国21世纪国家攻关项目(96-920-37-20)

摘　　要：目的研究重组人生长激素(rHGH)对慢性重型病毒性肝炎(chronic severe viral hepatitis,CSVH)患者生长激素(growth hormone,GH)-胰岛素样生长因子(insulin-like growth factor,GH-IGF)轴的变化以及其影响。方法CSVH患者25例(CSVH组),采用GH治疗,4.5 U/d,治疗前及治疗后,应用酶联免疫吸附(ELISA)法测定血清GH、胰岛素、胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3),并以15例正常献血员为对照(正常对照组)。结果CSVH组治疗前血清GHI、GF-1I、GFBP-3、胰岛素的水平分别与正常对照组比较(5.50±4.21)μg/L vs(1.57±1.27)μg/L,(80.45±69.99)μg/L vs(172.97±78.12)μg/L,(109.93±87.53)μg/L vs(373.41±119.07)μg/L,(31.99±49.87)mg/L vs(6.72±1.09)mg/L,差异有统计学意义(P<0.05或P<0.001);存活的CSVH患者治疗后血清IGF-1I、GFBP-3的水平明显增加(P<0.05),GH、胰岛素水平有降低趋势,但差异无统计学意义。结论CSVH患者GH-IGF轴发生显著异常变化。初步的临床结果显示,rHGH治疗可缓解CSVH患者的GH抵抗状态及增加肝脏IGF-1I、GFBP-3的合成,并对改善患者的营养和代谢方面有重要意义。Objective To investigate the influence of recombined human growth hormone （rHGH） on the growth hormone（GH） and insulln-like growth factor（GH-IGF） axes in the patients with chronic severe viral hepatitis （CSVH）. Methods Twenty-five patients with CSVH（CSVH group） were treated with GH 4.5 U/d. GH,insulin-like growth factor 1 （IGF-1）, insulin-like growth factor binding protein-3 （IGFBP-3） and insulin were deterimined using enzyme-linked immunosorbent assay（ELISA） before and after treatment. Meanwhile, 15 blood donors served as normal controls （normal control group）. Results Before treatment,the serum GH,IGF-1 and IGFBP-3,insulin level of CSVH group had more difference than those of normal control group （5.50±4.21） μg/L vs （1.57± 1.27） μg/L, （80.45 ± 69.99） μg/L vs （172.97±78.12） μg/L,（109.93±87.53） μg/L vs （373.41±119.07） μg/L,（31.99±49.87） mg/L vs （6.72 ± 1.09） mg/L （ P 〈 0.05-0. 001）. After rhGH treatment, IGF-1, IGFBP-3 were increased significantly in survival CSVH patients（ P 〈0.01） ,while GH and insulin had a tendency of decrease but no significance（ P 〉0. 05）. Conelusion GH-IGF axes of CSVH patients were abnormally changed, rhGH treatment may improve GH resistant state of CSVH patients and increase synthesization of IGF-1, IGFBP-3. rHGH plays an important role in improving nutrition and metabolism of the patients.

关 键 词：肝炎 病毒性 人 促生长素 胰岛素样生长因子Ⅰ 重组蛋白质类 酶联免疫吸附 

分 类 号：R512.6[医药卫生—内科学]