Liang Zhigang, Liu Xilin, Li Jiang, Huo Lizhen, Liang Darong
Department of Burns and Plastic Surgery, Guang Zhou Red Cross Hospital, 510220 Guangdong Province, P.R. China.
Zhonghua Shao Shang Za Zhi. 2002 Feb;18(1):49-51.
To explore the effects of recombinant human growth hormone (rhGH) on the serum levels of cytokines in severely burned patients.
Thirty-six burn patients were enrolled in the study and were randomly divided into 3 groups according to the rhGH dosage used, i.e. small (0.3 IU.kg(-1).d(-1), A), large (0.6 IU.kg(-1).d(-1), B) dose groups and control group (C, with normal saline). The rhGH was administered beginning from 3 postburn days (PBDs) and lasted for 20 days. The dynamic changes in the serum levels of TNFalpha, IL-6, IL-8 and LPS at different time points were observed.
When compared with those in C group, the serum levels of TNFalpha, IL-6 in A, B groups were decreased, especially in B group with earlier decrease and bigger range (P < 0.01). Simultaneously, the serum LPS level was decreased accordingly with evident positive correlation with the change in those cytokines (r = 0.9723, P < 0.01). But there was no obvious difference in serum IL-8 level among A, B and C groups (P > 0.05).
rhGH might decrease the production of postburn inflammatory mediators, especially in higher dose in dose-dependent manner for some degree. The clinical application of rhGH might be a supplementary measure in preventing and ameliorating postburn SIRS and MODS in severely burned patients.
探讨重组人生长激素(rhGH)对严重烧伤患者血清细胞因子水平的影响。
36例烧伤患者纳入本研究,根据rhGH使用剂量随机分为3组,即小剂量组(0.3IU·kg⁻¹·d⁻¹,A组)、大剂量组(0.6IU·kg⁻¹·d⁻¹,B组)和对照组(C组,给予生理盐水)。rhGH于烧伤后3天开始使用,持续20天。观察不同时间点血清肿瘤坏死因子α(TNFα)、白细胞介素6(IL-6)、白细胞介素8(IL-8)和脂多糖(LPS)水平的动态变化。
与C组相比,A、B组血清TNFα、IL-6水平降低,尤其是B组降低更早、幅度更大(P<0.01)。同时,血清LPS水平相应降低,与这些细胞因子的变化呈明显正相关(r=0.9723,P<0.01)。但A、B、C组血清IL-8水平差异无统计学意义(P>0.05)。
rhGH可能降低烧伤后炎症介质的产生,尤其是高剂量时在一定程度上呈剂量依赖性。rhGH的临床应用可能是预防和改善严重烧伤患者烧伤后全身炎症反应综合征(SIRS)和多器官功能障碍综合征(MODS)的一种辅助措施。