Yu Li-xin, Liu Yi-he, Shen Zhong-yang, Kang Mei-ni
Department of Transplantation, Tianjin First Central Hospital, Tianjin 300192, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007 Jul;19(7):390-3.
To evaluate influence of recombinant human growth hormone (rhGH) on nutritional status and immune function in early postoperative stage of liver transplantation including hepatic function, acute rejection and infection rate, in order to assess its safety in clinical use.
Sixty patients with non-malignant diseases of the liver in terminal stages were randomly divided into two groups: treatment group (rhGH treatment n=30) and control group (n=30). All the patients received the same nutritional support and immunodepressant treatment regimes. The patients in treatment group received rhGH 10 U hypodermically daily for 10 days 24 hours after liver transplantation. The following parameters including siderophilin, prealbumin, albumin, urea nitrogen, CD4/CD8, immunoglobulin G (IgG), IgM, IgA, growth hormone (GH), insulin-like growth factor-1 (IGF-1), aspartate aminotransferase (AST), alanine aminotransferase (ALT), dosage of insulin to control blood sugar (8-10 mmol/L) were determined on 1st, 4th, 8th, 14th days after the operation, and acute rejection rate after 28 days of operation (confirmed by liver acupuncture biopsy), and infection rate were also assessed.
Compared with control group, levels of siderophilin, prealbumin, CD4/CD8, GH, IGF-1 within 14 days in treatment group were increased significantly 14 days after the operation (all P<0.05), and level of urea nitrogen was decreased significantly (P<0.05). The level of albumin in treatment group was lower than that in control group 14 days after operation (P<0.05), while dosages of exogenous insulin were higher on 4th and 8th days after operation than that in control group (both P<0.05). There were no significant differences in levels of AST, ALT within 14 days, or acute rejection rate and infection rate within 28 days between two groups (all P>0.05).
rhGH can accelerate recovery of nutritional status in the early liver transplantation period. It does not show superiority in improving immune function and influence on recovery of hepatic function, acute rejection or infection rate. The safety has been challenged by inducing high blood sugar as a side effect.
评估重组人生长激素（rhGH）对肝移植术后早期营养状况和免疫功能的影响，包括肝功能、急性排斥反应及感染率，以评估其临床应用的安全性。
将60例终末期非恶性肝脏疾病患者随机分为两组：治疗组（rhGH治疗，n = 30）和对照组（n = 30）。所有患者均接受相同的营养支持和免疫抑制剂治疗方案。治疗组患者在肝移植术后24小时开始，每天皮下注射rhGH 10 U，共10天。分别于术后第1天、第4天、第8天、第14天测定以下参数：转铁蛋白、前白蛋白、白蛋白、尿素氮、CD4/CD8、免疫球蛋白G（IgG）、IgM、IgA、生长激素（GH）、胰岛素样生长因子-1（IGF-1）、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、控制血糖所需胰岛素剂量（8 - 10 mmol/L），并评估术后28天的急性排斥反应率（经肝穿刺活检确诊）及感染率。
与对照组相比，治疗组术后14天内转铁蛋白、前白蛋白、CD4/CD8、GH、IGF-1水平显著升高（均P < 0.05），尿素氮水平显著降低（P < 0.05）。术后14天治疗组白蛋白水平低于对照组（P < 0.05），术后第4天和第8天外源胰岛素剂量高于对照组（均P < 0.05）。两组术后14天内AST、ALT水平，以及术后28天内急性排斥反应率和感染率均无显著差异（均P > 0.05）。
rhGH可加速肝移植早期营养状况的恢复。在改善免疫功能及对肝功能恢复、急性排斥反应或感染率的影响方面未显示出优势。其安全性受到高血糖副作用的挑战。
