Mao Zhengchun, Chen Rukun, Zhao Lin
Department of Cardiothoracic Surgery, the 2nd Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, China.
Zhonghua Yi Xue Za Zhi. 2002 Jun 10;82(11):762-5.
To observe the effect of recombinant human growth hormone (rhGH) treatment on postoperative fatigue syndrome (POFS) in patients after cardiac surgery under cardiaopulmonary bypass (CPB).
60 patients undergoing open heart surgery were randomly divided (double blind trial) into two groups : group A (injected with rhGH, 4.5 U Bid for 5-7 days) and group B (administrated with placebo). The patients were asked to score their sense of fatigue (Christensen scores). Their 24-hour urine was collected to calculate the daily nitrogen balance. The serum growth hormone (GH) and plasma proteins were detected.
In the 4(th) day after operation, the level of fatigue was increased significantly in both groups, however, being lower in group A then in group B, and returned to the pre- operative level in the 8(th) postoperative day in group A (P < 0.01 ). The serum GH was similar in both groups before operation and was significantly increased on the first, fourth, and eighth days, especially the first day, postoperatively in group A (P < 0.01). The plasma total protein and albumin were similar in both groups before operation and on the first and fourth days postoperatively. On the 8(th) day postoperatively the plasma TP and albumin were significantly higher in group A than in group B (P < 0.05 and P < 0.01 respectively). The plasma retinol binding protein (RBP), prealbumin (PA), and transferrin (TFN) were similar in both groups before operation, on the first day after operation the plasma PA and TFN were lower than before operation in both groups. On the first postoperative day, the plasma RBP was higher in group A than in group B (P < 0.05), on the fourth day after operation the plasma PA and TEN were significantly higher in group A than in group B (P < 0.01). The time needed to wean from mechanical ventilation was 15.44 +/- 5.66 hr and 22.66 +/- 10.66 hr in groups A and B respectively (P < 0.01). In group A four patients established positive nitrogen balance on the second postoperative day and all patients in group B failed to obtain positiver nitrogen balance till the seventh postoperative day (P < 0.01).
观察重组人生长激素（rhGH）治疗对体外循环（CPB）心脏手术后患者术后疲劳综合征（POFS）的影响。
60例行心脏直视手术的患者被随机分为（双盲试验）两组：A组（注射rhGH，4.5 U，每日两次，共5 - 7天）和B组（给予安慰剂）。要求患者对其疲劳感进行评分（克里斯滕森评分）。收集其24小时尿液以计算每日氮平衡。检测血清生长激素（GH）和血浆蛋白。
术后第4天，两组疲劳程度均显著增加，但A组低于B组，且A组在术后第8天恢复至术前水平（P < 0.01）。两组术前血清GH相似，术后第1天、第4天和第8天，尤其是第1天，A组血清GH显著升高（P < 0.01）。两组术前及术后第1天和第4天血浆总蛋白和白蛋白相似。术后第8天，A组血浆总蛋白和白蛋白显著高于B组（分别为P < 0.05和P < 0.01）。两组术前血浆视黄醇结合蛋白（RBP）、前白蛋白（PA）和转铁蛋白（TFN）相似，术后第1天两组血浆PA和TFN均低于术前。术后第1天，A组血浆RBP高于B组（P < 0.05），术后第4天，A组血浆PA和TFN显著高于B组（P < 0.01）。A组和B组脱机所需时间分别为15.44±5.66小时和22.66±10.66小时（P < 0.01）。A组4例患者在术后第2天建立正氮平衡，B组所有患者直到术后第7天均未获得正氮平衡（P < 0.01）。
1）外源性rhGH的应用改善了POFS症状，缩短了POFS持续时间，缩短了脱机所需时间，提高了血浆白蛋白、PA、TFN和RBP水平，并改善了负氮平衡。2）急性期血浆蛋白（如PA、TFN和RBP）是POFS可靠的生化指标。
Zotero 插件