谷氨酰胺联合重组人生长激素治疗重度烧伤的临床效果观察

摘要

Objective To observe and discuss the clinical effect and safety of glutamine combined with recombinant human growth hormone (rhGH) in the treatment of severe burn. Method 72 cases of severely burned patients admitted in our hospital from November 2013 to November 2015 were randomly divided into 3 groups, 24 cases in each group. Patients in group A were treated with routine treatment+rhGH+glutamine;patients in group B were treated with routine treatment + rhGH;and patients in group C were treated with routine treatment. The levels of total plasma protein, albumin, glutamine, fasting blood glucose (FBG), IgA, IgG, IgM before and after treatment and wound healing rate, wound healing time and total hospital stay after 21-day treatment were compared among three groups. Result After treatment, levels of total plasma protein, albumin, glutamine, IgA, IgG of group A and group B were higher than group C (P < 0.05), and the levels of above indexes of group A were higher than group B (P<0.05). 21 days after treatment, wound healing rates of group A and group B were higher than group C (P<0.05), wound healing time and total hospital stay were shorter than group C (P<0.05);wound healing rate of group A was higher than group B (P<0.05), wound healing time and total hospital stay were shorter than group B (P<0.05). Conclusion Glutamine combined with rhGH can improve the levels of serum total protein, albumin, glutamine of severe burned patients, and can improve the immune status of body, effectively promote the synthesis of immunoglobulin, accelerate wound healing.%目的观察并探讨谷氨酰胺联合重组人生长激素（recombinant human growth hormone，rhGH）治疗重度烧伤的临床效果及其安全性。方法将2013年11月至2015年11月本院收治的重度烧伤患者72例随机分为A、B、C三组，每组各24例。A组患者采用烧伤常规治疗＋rhGH＋谷氨酰胺治疗， B组患者采用烧伤常规治疗＋rhGH治疗，C组患者采用烧伤常规治疗。比较三组患者治疗前后血浆总蛋白、清蛋白、谷氨酰胺、空腹血糖、免疫球蛋白（Ig）A、IgG、IgM水平变化以及治疗后21天的创面愈合率、创面愈合时间、总住院时间。结果治疗后A组和B组患者血浆总蛋白、清蛋白、谷氨酰胺、IgA、IgG水平均高于C组（P＜0.05），且A组患者上述指标水平均高于B组（P＜0.05）。治疗后21天，A组和B组患者创面愈合率均高于C组（P＜0.05），创面愈合时间和总住院时间均短于C组（P＜0.05）；A组患者治疗后创面愈合率高于B组（P＜0.05），创面愈合时间和总住院时间均短于B组（P＜0.05）。结论谷氨酰胺联合rhGH可以提高重度烧伤患者血浆总蛋白、清蛋白、谷氨酰胺水平，改善机体的免疫状况，有效促进Ig的合成，加快创面愈合。