Thomas Suchmor, Wolf Steven E, Chinkes David L, Herndon David N
Department of Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children, 815 Market Street, Galveston, TX 77550, USA.
Burns. 2004 Nov;30(7):675-9. doi: 10.1016/j.burns.2004.03.006.
Administration of growth hormone (GH) to burned children decreases acute phase proteins and increases constitutive proteins when used during the acute hospitalization. Treatment during convalescence has not been examined.
Seventy-six children with total body surface area burned (TBSAB) >/=40% were randomized to either placebo or GH (0.05 mg/kg/day) from discharge to 1 year after burn. Subjects were followed for an additional year. Levels of constitutive proteins and acute phase proteins were measured at discharge and 6, 9, 12, 18, and 24 months. Data are expressed as mean +/- S.E.M.
Albumin and transferrin levels increased during convalescence to the normal range but pre-albumin and retinol binding protein (RBP) levels remained below normal for at least 24 months. Acute phase proteins alpha(1)-acid glycoprotein, C-reactive protein, and haptoglobin decreased (P < 0.05) but alpha(2)-macroglobulin increased from discharge to 6 months. C-3 complement remained elevated for at least 2 years after burn. Changes were similar in both groups with no effect for GH treatment.
Some hepatic acute phase and constitutive proteins remain abnormal even 2 years after injury. GH treatment during convalescence has no effect on hepatic acute phase protein changes.
在急性住院期间给烧伤儿童使用生长激素（GH）可降低急性期蛋白水平并增加组成性蛋白水平。但尚未对恢复期的治疗效果进行研究。
76名烧伤总面积（TBSAB）≥40%的儿童从出院至烧伤后1年被随机分为安慰剂组或GH组（0.05mg/kg/天）。受试者又被随访了1年。在出院时以及6、9、12、18和24个月时测量组成性蛋白和急性期蛋白水平。数据以均值±标准误表示。
恢复期白蛋白和转铁蛋白水平升至正常范围，但前白蛋白和视黄醇结合蛋白（RBP）水平至少24个月仍低于正常。急性期蛋白α1-酸性糖蛋白、C反应蛋白和触珠蛋白水平下降（P<0.05），但α2-巨球蛋白从出院至6个月时升高。烧伤后C-3补体至少2年持续升高。两组变化相似，GH治疗无影响。
即使在受伤2年后，一些肝脏急性期蛋白和组成性蛋白仍异常。恢复期使用GH治疗对肝脏急性期蛋白变化无影响。
