摘要:
Objective To investigate the immune protective effect of recombinant growth hormone on chronic obstructive pulmonary disease ( COPD) patients with typeⅡin respiratory failure during the application of ventilator.Methods 52 patients with COPD with respiratory failure in Taizhou City Hospital from July 2014 to November 2015 in this study who were treated with ventilator therapy were divided into two groups.The control group received routine treatment, and the treatment group received more with recombinant growth hormone 8 U/d subcutaneous injected.Before and after treatment 14 days,determination of nutritional indicators,immune function,inflammatory markers and indicators of oxidative stress.Results Compared with before treatment,levels of total protein,albumin,transferrin and fibronectin in 2 groups after treatment increased,levels of IgM,IgG,CD4 +,CD8 +and CD4 +/CD8 +increased,levels of TNF-α,IL-8 and CRP decreased,levels of MDA,GSH and TAO decreased,levels of SOD increased(P<0.05), compared with the control group,levels of total protein,albumin,transferrin and fibronectin in the treatment group were higher,levels of IgM,IgG,CD4 +, CD8 +and CD4 +/CD8 +were higher,levels of TNF-α,IL-8 and CRP were lower,levels of MDA,GSH and TAO were lower,levels of SOD were higher (P<0.05).Conclusion Recombinant growth hormone has immune function protective effect on the COPD patients with type II respiratory failure in the process of breathing machine, which can improve the nutritional index and reduce the inflammatory reaction.%目的:探讨重组生长激素对慢性阻塞性肺疾病(chronic obstructive pulmonary disease ,COPD)合并Ⅱ型呼吸衰竭患者应用呼吸机过程中的免疫保护作用。方法选取2014年7月~2015年11月台州市立医院符合纳入标准的COPD合并Ⅱ型呼吸衰竭均应用呼吸机辅助治疗患者52例,按随机数字表法分为对照组与研究组,每组26例。对照组予以常规治疗,研究组在常规治疗基础上予以重组生长激素8 U/d皮下注射治疗。治疗前和治疗14 d后采血测定营养指标、免疫功能指标、炎症因子指标及氧化应激指标。结果与治疗前比较,2组治疗后总蛋白、白蛋白、转铁蛋白及纤维连接蛋白含量升高,IgM、IgG及CD4+、CD8+和CD4+/CD8+含量升高,肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白介素8(interleukin-8,IL-8)及C反应蛋白(C reactive protein,CRP)含量降低,丙二醛(malondialdehyde,MDA)、谷胱甘肽(glutathione,GSH)及总抗氧化能力(total antioxidant capacity,TAO)含量降低,超氧化物歧化酶(superoxide dismutase,SOD)含量升高(P<0.05);与对照组比较,研究组治疗后总蛋白、白蛋白含量较高,IgM、IgG及CD4+、CD8+和CD4+/CD8+含量较高,TNF-α、IL-8及CRP含量较低,MDA、GSH及TAO含量较低,SOD含量较高( P<0.05)。结论重组生长激素对COPD合并Ⅱ型呼吸衰竭患者应用呼吸机过程中的免疫功能具有保护作用,能提高营养指标,降低炎症反应。