观察严重烧伤患者应用重组人生长激素时机不同对糖代谢影响.docVIP

观察严重烧伤患者应用重组人生长激素时机不同对糖代谢影响 　　【摘要】 目的 观察严重烧伤患者应用重组人生长激素（rhGH）时机不同对糖代谢的影响。方法 选择住院严重烧伤患者65例，随机分为rhGH治疗1组(GH1组)、rhGH治疗2组(GH2组)和对照组。GH 1组，从烧伤后48 h开始，肌内注射rhGH 0．3 IU/(kg#8226;d),连续14 d；GH 2组，从烧伤后第7天开始行rhGH治疗，余同GH 1组。对GH 1组、GH 2组，分别首次用药前及用药后3、7、14、21 d检测血糖浓度。与GH 1组和GH 2组上述指标检测各时相点相对应，检测对照组血糖浓度。结果 GH 1和GH 2两组血糖水平在14 d用药期间均明显高于对照组(P0．05)。结论 rhGH应用于严重烧伤患者，虽然有明显升高血糖的作用，但其升高程度与应用rhGH时机早晚无明显时效关系。 　　【关键词】 烧伤；生长激素(人)；糖代谢 　　 　　Investigate the influence of recombinant human growth hormone(rhGH)on the glycometabolism in patients with extensive and full-thickness burn at different stages 　　 　　JIA Jun,SONG Guo-dong,MA Yin-dong,et al.Department of Burns,Jinan Centrol Hospital attached to Shandong University,Shandong 250013,China. 　　 　　【Abstract】 Objective To investigate the influence of recombinant human growth hormone(rhGH)on the glycometabolism in patients with extensive and full-thickness burn at different stages.Methods 65 patients were randomly divided into three groups,control,GH1 group and GH2 group.The patients in GH1 group were administered with rhGH(0．3 IU/(kg#8226;d),i.m.)after 48 hours of born lasting for 14 days.The patients in GH2 group began the corresponding treatment after 7 days of born.The blood glucose concentration were observed on before medication and 3、7、14、21 days after medication.Results The blood glucose concentrations were evidently higher in GH1 group and GH2 group than in control group(P0．05).Conclusion The blood glucose concentration in patients with extensive and full-thickness burn can be obviously heightened by the application of rhGH,but its changing extent have no obvious time-effect relationship with the stage of application. 　　【Key words】 Burns；Recombinant human growth hormone；Glycometabolism 　　 　　近10年来，随着重组人生长激素(rhGH)应用范围的扩大和基础研究的深入，显示出良好的应用前景。人生长激素(hGH)的主要生物学功能是直接的物质代谢作用和间接的促生长作用。但在其应用过程中也存在不良反应，其中高血糖就是一个比较明显的不良反应，也是引起关于rhGH用药时机争议的主要原因。为了探讨rhGH应用时机不同对烧伤患者糖代谢影响，笔者进行如下临床研究。 　　 　　1 资料与方法 　　 　　1．1 病例选择及分组 2000年1月至2006年12月，选择住院严重烧伤患者65