rhGH对老年多器官功能不全患者CD47、L-选择素及高级氧化蛋白产物表达的影响  

Effects of recombinant human growth hormone on the expression of CD47,L-selectin and advanced oxidation protein products in elderly patients with multiple organ dysfunction syndrome

作　　者：刘军[1] 甄平[1] 李旭升[1] 李慎松[1] 田琦[1] 杨洁 何晓乐[3] 

机构地区：[1]兰州军区总医院骨科,兰州730000 [2]兰州军区28分部西关干休所,西安710000 [3]第四军医大学西京医院老年病科,西安710032

出　　处：《解放军医学杂志》2015年第2期137-141,共5页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金(81370927);陕西省自然科学基金(2013JM4009)~~

摘　　要：目的观察重组人生长激素(rh GH)对老年多器官功能不全(MODSE)患者膜糖蛋白CD47、L-选择素及高级氧化蛋白产物(AOPPs)表达的影响。方法 66例MODSE患者随机均分为对照组(n=33,给予常规治疗)及治疗组(n=33,在常规治疗基础上加用rh GH)。所有患者均于治疗前及治疗后第3、14、28天取静脉血,流式细胞仪检测血清CD47阳性率,ELISA和分光光度计法检测L-选择素及AOPPs浓度,并观察两组患者APACHEⅢ评分的变化。结果与治疗前比较,对照组和治疗组的CD47阳性率增高,AOPPs浓度、L-选择素水平及APACHEⅢ评分降低,差异均有统计学意义(P<0.05)。与对照组比较,治疗组CD47阳性率增高(P<0.05),AOPPs浓度降低,L-选择素水平下降,APACHEⅢ评分降低,病死率降低,差异均有统计学意义(P<0.05)。治疗组内观察,与治疗后第3天比较,第14天CD47阳性率增高,AOPPs浓度降低,L-选择素水平下降,APACHEⅢ评分降低,差异均有统计学意义(P<0.05);与治疗后第14天比较,第28天CD47阳性率增高,AOPPs浓度降低,L-选择素水平下降,APACHEⅢ评分降低,差异均有统计学意义(P<0.05)。结论 rh GH可增强MODSE患者的免疫功能,减轻氧化应激及炎症反应,并可降低病死率。Objective To investigate the effects of recombinant human growth hormone （rhGH） on the expression of CD47, L-selective action hormone （L-selectin）, and advanced oxidation protein products （AOPPs） in elderly patients with multiple organ dysfunction syndrome （MODSE）. Methods Sixty-six MODSE patients were randomly and equally divided into two groups （33 each）： control group （received conventional treatment only） and rhGH treatment group （received conventional and rhGH treatment）. Venous blood was taken from all the subjects before treatment and 3rd, 14th and 28th day after treatment. Serum CD47 was detected by flow cytometry, L-selectin and AOPPs concentrations were determined with ELISA and spectrophotometry. The changes in APACHE Ⅲ score in the two groups were also observed. Results Compared with that before treatment, the positive rate of CD47 was increased, meanwhile the AOPPs concentrations, L-selectin levels and APACHE Ⅲ scores declined markedly in both groups after treatment （P〈0.05）. Compared with that in control group, the positive rate of CD47 increased more significantly, while the AOPPs concentrations, L-selectin levels, APACHE Ⅲ scores and mortalities declined more significantly in rhGH treatment group （P〈0.05）. In the rhGH treatment group, the positive rate of CD47 increased, the AOPPs concentrations, while L-selectin levels and APACHE Ⅲ scores declined markedly on the 14th day compared with those on the 3rd day and on the 28th day as compared with that on the 14th day after treatment （P〈0.0S）. Conclusion rhGH may enhance the immune function and reduce oxidative stress, inflammatory reaction, and mortality in elderly patients with MODSE.

关 键 词：人生长激素 多器官功能衰竭 抗原 CD47 L选择素 高级氧化蛋白产物 

分 类 号：R592[医药卫生—老年医学]