Demling Robert H, DeSanti Leslie
Department of Surgery, Trauma and Burn Center, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Burns. 2003 Dec;29(8):793-7. doi: 10.1016/j.burns.2003.08.003.
Weight loss and lean mass loss from burn induced catabolism can be more rapidly restored when the anabolic steroid oxandrolone is added to optimum nutrition compared to nutrition alone. Our purpose in this study was to determine whether the regained lean body mass (LBM) is retained 6 months after stopping oxandrolone. Forty-five severe burn patients, entering the recovery phase were randomized into a nutrition group alone or with the addition of oxandrolone, 20mg per day upon admission to the acute burn rehabilitation (RH) unit. Oxandrolone was discontinued after at least 80% of the involuntary weight loss occurring in the acute burn period, was restored. Body composition was measured using bioelectric impedence analysis (BIA). We found that patients receiving oxandrolone, in the rehabilitation unit, regained weight and lean mass two to three times faster than with nutrition alone. The difference was statistically significant (P<0.05). All patients were discharged from RH on a nutrition and exercise program and monitored in the outpatient burn center. After 6 months, body weight and body composition were again measured. We found that the body weight and lean mass which was restored during RH, was maintained 6 months after discontinuation of oxandrolone. Lost lean mass was not yet restored in the nutrition alone group. We can conclude that body weight and lean mass which is lost, due to burn induced catabolism, can be effectively restored in the post-burn recovery period with oxandrolone. The body weight and lost lean mass which is regained, is maintained 6 months after stopping the drug.
与单纯营养支持相比,在最佳营养方案中添加合成代谢类固醇氧雄龙时,烧伤诱导的分解代谢导致的体重减轻和瘦体重损失能更快恢复。本研究的目的是确定停用氧雄龙6个月后恢复的瘦体重是否能得以维持。45名进入康复期的重度烧伤患者被随机分为单纯营养组或加用氧雄龙组,后者在进入急性烧伤康复(RH)单元时每天服用20mg氧雄龙。在急性烧伤期发生的至少80%的非自愿体重减轻恢复后停用氧雄龙。使用生物电阻抗分析(BIA)测量身体成分。我们发现,在康复单元中,接受氧雄龙治疗的患者体重和瘦体重恢复速度比单纯营养支持快两到三倍。差异具有统计学意义(P<0.05)。所有患者均按照营养和运动方案从RH出院,并在门诊烧伤中心接受监测。6个月后,再次测量体重和身体成分。我们发现,在RH期间恢复的体重和瘦体重在停用氧雄龙6个月后得以维持。单纯营养组丢失的瘦体重尚未恢复。我们可以得出结论,烧伤诱导的分解代谢导致的体重和瘦体重损失在烧伤后恢复期可通过氧雄龙有效恢复。恢复的体重和丢失的瘦体重在停药6个月后得以维持。