Møller J, Jensen M B, Frandsen E, Møller N, Kissmeyer P, Laurberg S
Department of Surgery L, Aarhus University Hospital, Denmark.
Clin Endocrinol (Oxf). 1998 Nov;49(5):597-602. doi: 10.1046/j.1365-2265.1998.00561.x.
To investigate the possible beneficial effects of growth hormone (GH) in catabolic patients we examined the impact of GH on body fluid distribution in patients with ulcerative colitis undergoing elective abdominal surgery.
Twenty-four patients (14 female, 10 male) aged 19-47 years were in a double-blinded study randomly assigned to receive either placebo (n = 12) or GH (n = 12) 6 i.u. s.c. twice daily from 2 days before until 7 days after ileo-anal J pouch surgery. Extracellular and plasma volume (ECV, PV) were determined using 82Br and 125I albumin dilution at day -2 and at day 7, and body composition was estimated by dual X-ray absorptiometry and bioimpedance. Changes in body weight and fluid balance were recorded and hence intracellular volume was assessed.
During placebo treatment body weight decreased 4.3 +/- 0.6 kg; during GH treatment body weight was constant (P < 0.01). There was a positive fluid balance in the GH-treated patients compared to the placebo group (GH: 3.6 +/- 0.7 l; plc: -0.7 +/- 1.2 l, P < 0.01). ECV increased 2.12 +/- 0.70 l during GH and was unaffected during placebo (P = 0.02). PV was unchanged by GH and decreased 0.39 +/- 0.08 l during placebo administration (P = 0.03). Intracellular volume (ICV) decreased less during GH than during placebo (GH: -1.42 +/- 0.45; plc: -3.70 +/- 0.76; P = 0.02). Bioimpedance remained constant during GH administration and increased 60 +/- 9 ohm in the placebo-treated group (P < 0.05). Plasma renin and aldosterone remained unchanged in both study groups.
Body weight, plasma volume and intracellular volume is preserved during GH treatment in catabolic patients and ECV is increased. From a therapeutic point of view these effects may be desirable under conditions of surgical stress.
为研究生长激素（GH）对分解代谢患者可能的有益作用，我们检测了GH对择期腹部手术的溃疡性结肠炎患者体液分布的影响。
24例年龄在19 - 47岁之间的患者（14例女性，10例男性）参与了一项双盲研究，随机分为两组，一组接受安慰剂（n = 12），另一组接受生长激素（n = 12），剂量为6国际单位，皮下注射，每日两次，从回肠肛管J袋手术前2天至术后7天。在第-2天和第7天，使用82Br和125I白蛋白稀释法测定细胞外液和血浆容量（ECV、PV），并通过双能X线吸收法和生物电阻抗法评估身体成分。记录体重和液体平衡的变化，从而评估细胞内液容量。
在安慰剂治疗期间，体重下降4.3±0.6 kg；在生长激素治疗期间，体重保持稳定（P < 0.01）。与安慰剂组相比，生长激素治疗组患者的液体平衡为正值（生长激素组：3.6±0.7升；安慰剂组：-0.7±1.2升，P < 0.01）。生长激素治疗期间ECV增加2.12±0.70升，安慰剂治疗期间未受影响（P = 0.02）。生长激素对PV无影响，安慰剂给药期间PV减少0.39±0.08升（P = 0.03）。生长激素治疗期间细胞内液容量（ICV）的减少少于安慰剂治疗期间（生长激素组：-1.42±0.45；安慰剂组：-3.70±0.76；P = 0.02）。生长激素给药期间生物电阻抗保持稳定，安慰剂治疗组增加60±9欧姆（P < 0.05）。两个研究组的血浆肾素和醛固酮均保持不变。
在分解代谢患者的生长激素治疗期间，体重、血浆容量和细胞内液容量得以维持，且ECV增加。从治疗角度来看，在手术应激情况下，这些作用可能是有益的。
