生长激素对人工血管内皮化影响的临床观察  

EFFECT OF RECOMBINAN THUMAN GROWTH HORMONE ON ENDOTHELIALIZATION OF VASCULAR PROSTHESES

作　　者：张喆[1] 陈学明[1] 李晨宇[1] 冯海[1] 于宏志[1] 朱仁明[1] 蔡执敏[1] 

机构地区：[1]首都医科大学附属北京友谊医院血管外科,北京100050

出　　处：《中国修复重建外科杂志》2015年第6期756-760,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 通过对人工血管转流术后患者给予重组人生长激素（recombinant human growth hormone,rhGH）治疗,观察rhGH是否具有促进人工血管内皮化、抑制内膜增生、改善远期通畅率的作用。方法 2007年8月-2009年1月共收治94例下肢动脉硬化闭塞症患者,其中32例（34条患肢）符合选择标准纳入研究。采用随机表法将患者分为研究组（16例18条患肢）和对照组（16例16条患肢）。两组患者性别、年龄、病程、病变部位、泛大西洋学会联盟（TASC）分级及合并基础疾病比较,差异均无统计学意义（P〉0.05）,具有可比性。股浅动脉病变者行膝上股-腘动脉人工血管转流术,合并主髂动脉病变者同期行腹-双股＋股-腘动脉人工血管转流术。研究组患者于术后当日起每晚皮下注射rhGH 9 U,连续应用7 d;对照组同法给予生理盐水。所有患者于术后2周及3个月接受超声检查,观察股-腘人工血管通畅情况,测量管壁厚度。结果 对照组1例术后因急性血栓导致肾功能衰竭死亡。术后2周超声检查两组人工血管均未出现明显内膜增生,研究组与对照组管壁厚度分别为（0.13±0.02）cm和（0.15±0.03）cm,比较差异无统计学意义（t=—1.720,P=0.108）;术后3个月研究组与对照组管壁厚度分别为（0.17±0.06）cm和（0.26±0.09）cm,差异有统计学意义（t=—2.240,P=0.045）。两组患者均获随访,随访时间36～60个月,平均56.4个月。研究组和对照组人工血管5年一期通畅率分别为52.5%和35.7%,比较差异无统计学意义（χ2=1.470,P=0.225）。结论 rhGH具有促进人工血管内皮化的作用,临床上应用可抑制术后人工血管内膜过度增生。Objective To investigate whether the recombinant human growth hormone （rhGH） can promote endothelialization, inhibit vascular intimal hyperplasia, and improve long-term patency rate by the treatment of rhGH after vascular prostheses bypass. Methods Between August 2007 and January 2009, 94 patients with lower extremity arteriosclerotic occlusive disease were treated. Among them, 32 patients （34 limbs） who met the selection criteria were enroUed in this study. All cases were randomly divided into study group （16 cases, 18 limbs） and control group （16 cases, 16 limbs）. There was no significant difference （P〉O.05） in gender, age, disease time, location of lesions, the Trans-Atlantic Inter- Society Consensus （TASC） grade, and basic diseases between 2 groups. The patients with superficial femoral artery disease received above-knee femoro-popliteal prostheses bypass. The patients who had combined abdominal-iliac artery disease received concurrent abdominal-femoral and femoro-popliteal prostheses bypass. Subcutaneous injection of 9 U rhGH was given every night for 7 days in study group, and saline was applied in control group. Ultrasonography was taken after 2 weeks and 3 months of operation to observe the patency and measure the wall thickness of vascular prostheses. Results After operation, 1 patient of control group died of renal failure caused by acute thrombosis. After 2 weeks, ultrasonography showed no obvious intimal hyperplasia in 2 groups; the wall thickness was （0.13±0.02） cm in study group and （0.15±0.03） cm in control group, showing no significant difference （t= -1.720, P=0.108）. After 3 months, the wall thickness was （0.17±0.06） cm in study group and was （0.26＋0.09） cm in control group, showing significant difference （t= -2.240, P=0.045）. All cases were followed up 36-60 months （mean, 56.4 months）. The 5-year primary patency rate was 52.5% in study group and 35.7% in contro｜ group, showing no significant difference （X2=1.470, P=0.225）. Conclusi

关 键 词：重组人生长激素 人工血管 内皮化 内膜增生 

分 类 号：R654.4[医药卫生—外科学]