基因重组人生长激素对AECOPD患者大脑能量代谢的影响研究及与氧分压的关系  

Study on the effect of recombinant human growth hormone on brain energy metabolism in AECOPD patients and the relationship with oxygen partial pressure

作　　者：文文[1] 张雷[1] 柳德灵[1] 叶嘉[1] 赖国祥[1] 

机构地区：[1]南京军区福州总医院呼吸与危重症医学科,福州350025

出　　处：《国际呼吸杂志》2013年第17期1289-1292,共4页International Journal of Respiration

基　　金：福建省科技计划重点项目（2009Y0038）

摘　　要：目的 研究基因重组人生长激素（r-hGH）对慢性阻塞性肺疾病急性加重期（AECOPD）患者大脑能量代谢物质的改变的影响及与氧分压的关系.方法 34例AECOPD患者随机分成2组,每组均给予吸氧、抗生素、支气管扩张剂、激素、祛痰药等治疗,A组为对照组（17例）,标准的营养支持治疗；B组为生长激素治疗组（17例）,在A组常规治疗基础上,加用r-hGH.通过1 HMRS对34例AECOPD患者常规治疗及r-hGH治疗前后大脑能量代谢物质进行检查,测定大脑顶-颞部和枕部的NAA/Cr、Cho/Cr、MI/Cr的比值,并测定患者氧分压,研究r-hGH对大脑能量代谢物质改变的影响及与患者氧分压是否具有相关性.结果 B组与A组比较,治疗后PaO2高于A组,P＜0.05.B组治疗前PaO2低于治疗后PaO2,P＜0.01.A组和B组相比,A组治疗后顶-颞部及枕部NAA/Cr均低于B组治疗后,P＜0.05,A组顶-颞部MI/Cr治疗后低于B组治疗后,P＜0.05.B组治疗前顶-颞部及枕部NAA/Cr均低于治疗后,P ＜0.05,B组顶-颞部MI/Cr治疗前低于治疗后,P＜0.01.顶-颞部及枕部NAA/Cr与PaO2呈显著正相关,相关系数分别为0.558和0.398,顶-颞部及枕部MI/Cr与PaO2呈显著正相关,相关系数分别为0.555和0.372.结论 r-hGH能改善AECOPD患者大脑能量代谢状态,和氧分压有一定的相关性.Objective To study the effect of recombinant human growth hormone on brain energy metabolism in AECOPD patients and the relationship with oxygen partial pressure.Methods Totally 34 cases of AECOPD patients were divided into 2 groups,each group were given oxygen,antibiotics,bronchodilator,hormones,expectorant etc,A group for the control group,we give the standard nutrition support therapy,B group for growth hormone treatment group,on the basis of conventional treatment,we added with recombinant human growth hormone （hGH）.All patients were taken 1 HMRS examination before and after recombinant human growth hormone treatment,the ratios of NAA/Cr,Cho/Cr and MI/Cr of parieto-temporal and occipital areas of the brain were detected.Blood gas analysis were also used to detect partial pressure of oxygen and to learn the relationship between the brain energy metabolism changes and partial pressure of oxygen partial pressure.Results Compared with group A,PaO2 of group B is higher than group A after treatment,P ＜0.05.Of Group B PaO2 is higher after treatment,P ＜0.01.Compared with group B,NAA/Cr of parieto-temporal and occipital areas of the brain in group A were lower after treatment,P ＜0.05,MI/Cr of parieto-temporal s lower,P ＜0.05.NAA/Cr of parieto -temporal and occipital areas of the brain in group B were higher after treatment,P ＜0.05,MI/Cr of parieto-temporal is higher after treatment,P ＜0.01.NAA/Cr of parieto-temporal and occipital areas of the brain were significantly positive correlated with PaO2,correlation coefficients were 0.558 and 0.398,MI/Cr of parieto-temporal and occipital areas of the brain were also significantly positive correlated with PaO2,coefficients were 0.555 and 0.372.Conclusions Recombinant human growth hormone can improve the cerebral energy metabolism station in AECOPD patients and has some relationship with oxygen partial pressure.

关 键 词：基因重组人生长激素 慢性阻塞性肺疾病 磁共振氢质子波谱 大脑能量代谢状态 

分 类 号：R563.9[医药卫生—呼吸系统]