重组人生长激素联合谷氨酰胺强化营养对重症COPD急性发作的治疗价值

摘要

Objective To investigate the effects of combination recombinant human growth hormone( r-hGH) and glutamine on severe AECOPD. Methods Twenty patients with severe AECOPD who received standard nutritional support were enrolled as control group A; 20 patients with severe AECOPD who received standard nutritional support and glutamine were designed as group B; and 20 patients with severe AECOPD who received standard nutritional support, glutamine and r-hGH were included as group C. All subjects received anti-infection therapy, phlegm-expelling formula, bronchodilators,and mechanical ventilation. The levels of ALB, TRF, PA, RBP, TLC, PaCO2 were observed before and 10 days after treatment. Moreover, the levels of RI,MV, duration of ventilatory support, and overall hospital stay for all subjects were analyzed. Results Compared with gourp A and B, subjects in group C had a significant increase in TRF, PA, RBP and TLC ( P ＜ 0. 05) and remarkable decrease in duration of ventilatory support, and overall hospital stay ( P ＜0. 05) . Conclusions Combination r-hGH and glutamine, could induce better trophic status, and reduce duration of ventilatory support, and overall hospital stay on severe AECOPD.%目的 探讨重组人生长激素(r-hGH)联合谷氨酰胺强化营养支持对重症慢性阻塞性肺疾病急性发作(AECOPD)的治疗价值.方法 60例重症AECOPD病人随机分成3组,均给予抗感染、祛痰药、支气管扩张剂、机械通气治疗,A组为对照组,标准的营养支持治疗;B组为谷氨酰胺组,在给以标准的等氮量、等热卡的营养支持的基础上,外加静脉补充谷氨酰胺(力肽,华瑞制药有限公司);C组为联合应用谷氨酰胺和生长激素组,在B组基础上,加用重组人生长激素(r-hGH).所有病人均于治疗前和治疗第10天,检测血清白蛋白(ALB)、转铁蛋白(TRF)、前白蛋白(PA)、视黄醉结合蛋白(RBP)、外周血淋巴细胞计数(TLC)、动脉血二氧化碳分压(PaC02),记录胰岛素用量(RI),每分钟通气量(MV),并比较机械通气时间和住院时间.结果 C组与A、B组相比:营养状况指标,TRF、PA、RBP、外周血琳巴细胞总数增加(P＜0.05);临床指标机械通气时间及住院时间均明显缩短(P＜0.05).结论 联合应用谷氨酰胺和r-hGH能促进重症AECOPD病人的蛋白合成,改善营养状况,减少带机时间和住院时间.