【摘要】 目的:重组人生长激素(rhGH)是通过基因工程人工合成的人生长激素,保持了与垂体分泌的生长激素(GH)相同的结构和功能,它在一些代谢性疾病、烧伤以及感染性疾病的治疗上发挥着重要作用。但迄今为止,rhGH在儿童尿道下裂术后治疗中的作用国内外未见报道。本文对rhGH在儿童尿道下裂术后治疗中的临床疗效进行了观察,为提高手术治疗尿道下裂的临床疗效,改善临床预后和治疗尿道下裂新药的开发提供理论及实验依据。方法:将84例尿道下裂手术后患者随机分为试验组和对照组,每组42例。对照组:常规应用抗生素和止血药,并给予伤口常规护理。试验组:在常规治疗的基础上,给予rhGH(赛增)0.2 U/(kg.d),每晚睡前皮下注射1次,疗程1周。观察临床疗效、排尿症状、外周血白细胞(WBC)计数、C反应蛋白(CRP)含量、CD4+和CD8+、IgM、IgG和IgA含量,白蛋白和总蛋白含量。结果:①试验组临床治愈34例,显效8例,治愈率为81.0%。对照组临床治愈28例,显效12例,无效2例,治愈率为66.7%,试验组临床疗效明显优于对照组;②对照组外周血CRP含量和WBC数较术前明显升高,但试验组外周血CRP含量和WBC数较术前无明显升高,且试验组明显低于对照组;③试验组血清白蛋白和总蛋白含量术后明显高于对照组;④试验组术后IgM、IgG和IgA含量均明显高于对照组;⑤试验组治疗后外周血CD4+、CD4+/CD8+比值与治疗前相比显著上升,而CD8+较治疗前相比含量下降,上述指标与治疗后的对照组比较亦具有显著性差异。结论:rhGH在儿童尿道下裂术后治疗中具有显著疗效,且无明显不良反应,其作用机制与其促进蛋白质合成,纠正负氮平衡,提高免疫功能有关。更多还原

【Abstract】 Objective: To evaluate the efficacy of recombinant human growth hormone(rhGH) in the postoperative treatment of hypospadias in children.Methods: A total of 84 male children with hypospadias treated by surgery were randomly divided into a control and an rhGH group of equal number,the former treated with antibiotics plus hemostatics with usual wound care,while latter,in addition,by subcutaneous injection of rhGH at 0.2 U/kg/d qd before bedtime for 7 days.Then we compared the two groups in the clinical efficacy,urinary symptoms,peripheral WBC count,C-reactive protein(CRP) level,ratio of CD4+ to CD8+ T lymphocytes in the peripheral blood,contents of serum albumin and total protein,and levels of IgM,IgG and IgA in the serum.Results: The total effectiveness rates in the rhGH and control groups were 81.0% and 66.7%,respectively,significantly higher in the former than in the latter(P<0.05).The levels of WBC and CRP in the peripheral blood were increased after treatment,but with no significant difference.The contents of serum albumin and total protein were higher before than after surgery.The levels of IgM,IgG and IgA were markedly elevated in the rhGH group as compared with the control.The ratio of CD4+ to CD8+ was significantly increased while the level of CD8+ remarkably decreased after treatment in comparison with pre-treatment.Conclusion: RhGH is effective and safe in the postoperative treatment of hypospadias in children,and its action mechanisms are associated with its promotion of protein synthesis,improvement of negative nitrogen balance and enhancement of immune function.更多还原