Jeschke Marc G, Finnerty Celeste C, Suman Oscar E, Kulp Gabriela, Mlcak Ronald P, Herndon David N
Shriners Hospital for Children, and Department of Surgery, University Texas Medical Branch, Galveston, Texas, USA.
Ann Surg. 2007 Sep;246(3):351-60; discussion 360-2. doi: 10.1097/SLA.0b013e318146980e.
Postburn long-term oxandrolone treatment improves hypermetabolism and body composition. The effects of oxandrolone on clinical outcome, body composition, endocrine system, and inflammation during the acute phase postburn in a large prospective randomized single-center trial have not been studied.
Burned children (n = 235) with >40% total body surface area burn were randomized (block randomization 4:1) to receive standard burn care (control, n = 190) or standard burn care plus oxandrolone for at least 7 days (oxandrolone 0.1 mg/kg body weight q.12 hours p.o, n = 45). Clinical parameters, body composition, serum hormones, and cytokine expression profiles were measured throughout acute hospitalization. Statistical analysis was performed by Student t test, or ANOVA followed by Bonferroni correction with significance accepted at P < 0.05.
Demographics and clinical data were similar in both groups. Length of intensive care unit stay was significantly decreased in oxandrolone-treated patients (0.48 +/- 0.02 days/% burn) compared with controls (0.56 +/- 0.02 days/% burn), (P < 0.05). Control patients lost 8 +/- 1% of their lean body mass (LBM), whereas oxandrolone-treated patients had preserved LBM (+9 +/- 4%), P < 0.05. Oxandrolone significantly increased serum prealbumin, total protein, testosterone, and AST/ALT, whereas it significantly decreased alpha2-macroglobulin and complement C3, P < 0.05. Oxandrolone did not adversely affect the endocrine and inflammatory response as we found no significant differences in the hormone panels and cytokine expression profiles.
In this large prospective, double-blinded, randomized single-center study, oxandrolone shortened length of acute hospital stay, maintained LBM, improved body composition and hepatic protein synthesis while having no adverse effects on the endocrine axis postburn, but was associated with an increase in AST and ALT.
烧伤后长期使用氧雄龙治疗可改善高代谢状态和身体组成。在一项大型前瞻性随机单中心试验中，尚未研究氧雄龙在烧伤急性期对临床结局、身体组成、内分泌系统和炎症的影响。
将烧伤面积超过40%的儿童（n = 235）随机分组（区组随机化，4:1），分别接受标准烧伤护理（对照组，n = 190）或标准烧伤护理加氧雄龙治疗至少7天（氧雄龙0.1 mg/kg体重，口服，每12小时1次，n = 45）。在整个急性住院期间测量临床参数、身体组成、血清激素和细胞因子表达谱。采用Student t检验或方差分析，随后进行Bonferroni校正，P < 0.05为差异有统计学意义。
两组的人口统计学和临床数据相似。与对照组（0.56 ± 0.02天/%烧伤）相比，氧雄龙治疗组患者的重症监护病房住院时间显著缩短（0.48 ± 0.02天/%烧伤），（P < 0.05）。对照组患者的去脂体重（LBM）减少了8 ± 1%，而氧雄龙治疗组患者的LBM得以保留（增加9 ± 4%），P < 0.05。氧雄龙显著增加血清前白蛋白、总蛋白、睾酮和AST/ALT，而显著降低α2-巨球蛋白和补体C3，P < 0.05。氧雄龙对内分泌和炎症反应无不良影响，因为我们发现激素指标和细胞因子表达谱无显著差异。
在这项大型前瞻性、双盲、随机单中心研究中，氧雄龙缩短了急性住院时间，维持了LBM，改善了身体组成和肝脏蛋白质合成，同时对烧伤后的内分泌轴无不良影响，但与AST和ALT升高有关。
