肠外营养联合重组人生长激素改善门静脉高压患者低蛋白血症的研究  

The effect of rhGH-enriched PN on the protein promoting function in hypoproteinemia patients with portal hypertension

作　　者：王彬[1] 沈洁 黄回[1] 刘颖斌[1] 周连妹[1] 

机构地区：[1]浙江大学医学院附属第二医院外科,杭州310009 [2]浙江黄岩第一医院外科

出　　处：《浙江医学》2002年第1期9-10,13,共3页Zhejiang Medical Journal

摘　　要：目的 探讨低热量肠外营养 (PN)联合应用重组人生长激素 (rhGH)对改善肝硬化门静脉高压患者低蛋白血症的作用。方法 选择年龄、肝功能分级 (Child方法 )和术式相似 ,血浆白蛋白<35g/L ,无黄疸及糖尿病的肝硬化门静脉高压患者36例 ,随机分为研究组和对照组 (各18例 )。两组患者术后均按公斤体重给予等热量、等氮PN治疗7d,研究组联合应用rhGH4.5U皮下注射 ,每日2次。术前和术后第3、8天监测血浆白蛋白和前白蛋白 (PA)水平 ,术后1周内连续测定24h尿尿素氮 ,同时观察记录两组患者术后精神及体力恢复情况。 结果研究组术后第4天7例接近正氮平衡 ,术后第7天全部达到正氮平衡 ;而对照组术后第7天全部处于负氮平衡 (P<0.01)。治疗后研究组PA由 (76.49±26.86)mg/L提高到 (89.08±22.84)mg/L ,对照组由 (76.78±17.89)mg/L上升到 (81.44±14.53)mg/L(均P<0.05) ,研究组较对照组上升更为明显 (P<0.05)。结论 低热量PN +rhGH治疗能促进肝硬化门静脉高压患者的蛋白质合成 。Objective The purpose of this study was to evaluate the protein-promoting effects of recombinant human growth hormone(rhGH) intensified parenteral nutrition (PN) in hypoproteinemia patients with por-tal hypertension.Methods Thirty-six patients were divided randomly into standard PN group(n=18) and PN+rhGH group(n=18).They received standard PN or PN+rhGH for 7 days respectively.The levels of plasma albumin and prealbumin (PA) were assayed on preoperative day and postoperative day 3(PoD 3) and 8(PoD 8).The levels of 24h UUN were detected on postoperative day 1 to 7.The mental and physical state were also observed and recorded.Results (1)In PN+rhGH group,patients were in positive nitrogen balance in PoD 3,all the patients returned to positive nitrogen balance in PoD 7.In PN group all the patients were still in negative nitrogen balance in PoD 7(P<0.01);(2)PA increased from (76.78±17.89)mg/L to (81.44±14.53)mg/L after treatment in PN group(P<0.05) and increased from(76.49±26.86)mg/L to (89.08±22.84)mg/L in PN+rhGH group(P<0.01);(3)PN+rhGH group recovered better in the body and mind fatigue.Conclusion The rhGH-enriched PN can improve nitrogen balance and plasma albumin levels in hypoproteinemia patients with protal hypertension.

关 键 词：肠外营养 重组人生长激素 肝硬化门静脉高压 低蛋白血症 

分 类 号：R459.3[医药卫生—治疗学]