Thomas Suchmor, Wolf Steven E, Murphy Kevin D, Chinkes David L, Herndon David N
Department of Surgery, Shriners Hospitals for Children and University of Texas Medical Branch, Galveston, 77550, USA.
J Trauma. 2004 Jan;56(1):37-44. doi: 10.1097/01.TA.0000108636.63225.63.
Acute phase protein production is a hallmark of severe burns. We wondered whether anabolic treatment with oxandrolone would affect these proteins.
Thirty-five children with > or =40% total body surface area burns were randomized to receive either placebo or oxandrolone (0.1 mg/kg by mouth twice daily) from postoperative day 5 to 1 year postburn. Levels of constitutive proteins and acute phase proteins were measured at admission; at discharge; and at 6, 9, and 12 months after burn. Total albumin supplementation and hepatic transaminases were also assessed.
Constitutive proteins such as albumin, prealbumin, and retinol-binding protein levels increased (p < 0.05), and acute phase proteins such as alpha 1-acid glycoprotein, C3 complement, alpha 2-macroglobulin, and fibrinogen levels significantly decreased in the oxandrolone group compared with placebo (p < 0.05). Albumin supplementation during the acute hospitalization was reduced in the oxandrolone group. Hepatic transaminases remained within normal levels.
Treatment with oxandrolone in severe burns significantly increases constitutive protein and reduces acute phase protein levels.
急性期蛋白产生是严重烧伤的一个标志。我们想知道用氧雄龙进行合成代谢治疗是否会影响这些蛋白。
35名烧伤面积达或超过40%体表面积的儿童被随机分组,从烧伤后第5天至烧伤后1年,分别接受安慰剂或氧雄龙(0.1毫克/千克,口服,每日两次)治疗。在入院时、出院时以及烧伤后6、9和12个月测量组成性蛋白和急性期蛋白水平。还评估了总白蛋白补充量和肝转氨酶。
与安慰剂组相比,氧雄龙组中白蛋白、前白蛋白和视黄醇结合蛋白等组成性蛋白水平升高(p<0.05),而α1-酸性糖蛋白、C3补体、α2-巨球蛋白和纤维蛋白原等急性期蛋白水平显著降低(p<0.05)。氧雄龙组在急性住院期间的白蛋白补充量减少。肝转氨酶保持在正常水平。
严重烧伤患者使用氧雄龙治疗可显著提高组成性蛋白水平并降低急性期蛋白水平。