【摘要】 目的观察重组人生长激素(rhGH)是否能抑制或减轻腹部外科术后疲劳综合征(POFS)的程度和持续时间。方法包括48例腹部外科中等以上手术患者,随机分为研究组和对照组,每组24例,研究组术后第3~9d每日皮下注射rhGH0.15U/(kg·d)。分别进行疲劳评分,并测定血清蛋白指标、氮平衡和体质量。结果术后第10d,研究组疲劳程度明显轻于对照组(P<0.05),血清纤维连接蛋白水平高于对照组(P<0.05);从术后使用rhGH的第1d开始,研究组即能达到正氮平衡,而且术后3~9d,研究组氮平衡优于对照组(P<0.05);两组间体质量指标均降低,差异无统计学意义。结论低剂量rhGH应用可以减轻POFS,促进正氮平衡,改善营养状况;血浆纤维连接蛋白水平是评价POFS严重程度及其治疗反应的有价值的指标。更多还原

【Abstract】 Objective This is a randomized controlled trial to evaluate the efficacy of recombinant human growth hormone (rhGH) in preventing the development or reducing the duration of postoperative fatigue syndrome (POFS). Methods Informed consent was obtained from each prospective subject. A total of 48 consecutive patients undergoing the elective abdominal operations were randomly divided into the rhGH group and the placebo group. The rhGH group was given daily rhGH 0.15 U/kg from day 3 to day 9 after operation. The two groups had similar nutritional intakes. Plasma proteins, fatigue (Christensen score) and body weight were investigated before and after operations. Nitrogen balance was measured from day 3 to day 9 after operation. Results On postoperative day 10, the fatigue score in rhGH group was significantly lower than that in control group (P<0.05); the level of fibronectin in rhGH group was significantly higher than that in control group (P<0.05). Furthermore, a positive nitrogen balance was achieved and kept in the rhGH-treated group during the postoperative period from the third day onward, whereas it was not achieved in the control group till day 9 postoperatively. Cumulative nitrogen balance was significantly higher in rhGH group than in control group (P<0.05). There was no significant difference between the two groups in weight loss after operation (P>0.05). Conclusion The application of low doses of recombinant human growth hormone can improve positive nitrogen balance and reduce the courses of POFS. The serum fibronectin level is proved to be a reliable biochemical indicator of POFS.更多还原