基因重组生长激素在撤机困难并呼吸肌疲劳的慢性阻塞性肺疾病患者中的应用  

Application of recombinant human growth hormone to patients with chronic obstructive pulmonary disease and respiratory muscle weakness difficult to off-line ventilation

作　　者：王思荣[1] 陈裕胜[1] 林材元[1] 黄昭[1] 

机构地区：[1]广州市第一人民医院危重症监护中心,510180

出　　处：《实用医学杂志》2008年第7期1135-1137,共3页The Journal of Practical Medicine

摘　　要：目的:探讨基因重组生长激素(rhGH)在接受机械通气的慢性阻塞性肺疾病(COPD)并呼吸肌疲劳、撤机困难患者中临床应用。方法:选择28例在我院ICU住院的COPD并呼吸衰竭患者,所有患者均接受机械通气治疗,且临床表现为呼吸肌疲劳明显、撤机困难。将患者分为rhGH组和对照组各14例,rhGH组每天皮下注射rhGH0.1U/kg,对照组接受生理盐水皮下注射,直至撤离呼吸机。对比两组患者死亡率、接受机械通气时间及治疗前后血清总蛋白、白蛋白、血糖变化的差异,同时比较rhGH组的预测死亡率及实际死亡率的差异。结果:与对照组相比,rhGH组接受机械通气时间明显缩短(P<0.05),血白蛋白浓度显著升高(P<0.05),实际死亡率较预测死亡率显著降低,但血糖变化没有明显差异。结论:rhGH应用于COPD并呼吸衰竭、呼吸肌疲劳的患者,可显著缩短机械通气时间及降低患者死亡率,同时改善患者营养状态,有助于呼吸机撤离。Objective To evaluate the benefit of recombinant human growth hormone （rhGH） applied to the patients with chronic obstructive pulmonary disease（COPD） and respiratory muscle weakness difficult to off-line ventilation. Methods Twenty-eight patients with COPD and respiratory failure difficult to off-line ventilation were divided into rhGH group （ n=14 ） who received rhGH 0.1 U/kg subcutaneous injection and control group （ n=14 ） who divided NS subcutaneous injection. Mortality, duration of mechanical ventilation, total serum protein, albumin and blood glucose were observed and compared in the two groups. Results As compared with control group, duration of mechanical ventilation was shortened （P 〈 0.05）, albumin level was increased（P 〈 0.05）, real mortality decreased （P 〈 0.05） significantly in rhGH group. But no obvious change was observed in blood glucose level. Conclusion Administration of rhGH on mechanically ventilated patients with COPD and respiratory failure can effectively shorten the mechanical ventilation duration, reduce the mortality rate, improve the nutrition status and respiratory muscle strength.

关 键 词：肺疾病 慢性阻塞性 生长激素 呼吸肌疲劳 机械通气 

分 类 号：R563.9[医药卫生—呼吸系统]