Rasmussen L H, Garbarsch C, Schuppan D, Moe D, Hørslev-Pedersen K, Gottrup F, Steenfos H
Dept. of Surgery, Herlev Hospital, Copenhagen, Denmark.
Eur J Surg. 1995 Mar;161(3):157-62.
To investigate dose response profiles of human growth hormone in soft connective tissue healing when it is given locally in subcutaneous wound chambers.
Placebo controlled parallel study.
Institute of Medical Anatomy, Denmark.
36 male Sprague Dawley rats, in three group of 12.
Stainless steel wire mesh cylinders 7 mm in diameter and 20 mm long were implanted subcutaneously in pairs in the upper and lower back on either side of the midline in three groups of male Sprague Dawley rats. Two groups were each given two different doses of growth hormone (group 1, 0.2 and 0.7 IU; and group 2, 0.02 and 2 IU) in two cylinders and vehicle alone in the two cylinders on the opposite side. Group 3 were given vehicle alone in two cylinders and needle puncture (sham) on the opposite side. Injections of growth hormone or vehicle (placebo) were given every three days for 16 days.
Body weight, weight of granulation tissue, and concentrations of hydroxyproline and aminoterminal propeptide of procollagen type III.
The dose response curves for weight of granulation tissue and deposition of collagen were upward convex (ANOVA p < 0.001 and 0.001, respectively). Growth hormone in doses of 0.2 and 0.7 IU stimulated formation of granulation tissue to means of 180% (95% confidence interval (Cl) 149% to 210%) and 174% (95% Cl 148% to 200%) more than in the placebo treated cylinders (group 3) (p < 0.05 and < 0.01, respectively). Doses of 0.2 and 2 IU, however, had less effect. The placebo cylinders in animals in groups 1 and 2 contained a mean of 157% (95% Cl 137% to 177%) more granulation tissue than the cylinders in group 3, indicating that locally applied growth hormone also had a systemic effect.
The clinical use of topical growth hormone in wound healing may be complicated by the relatively narrow therapeutic interval.
研究皮下伤口腔室局部给予人生长激素时在软结缔组织愈合中的剂量反应情况。
安慰剂对照平行研究。
丹麦医学解剖研究所。
36只雄性斯普拉格 - 道利大鼠,分为三组,每组12只。
在三组雄性斯普拉格 - 道利大鼠中线两侧的上背部和下背部成对皮下植入直径7毫米、长20毫米的不锈钢丝网圆柱体。两组在两个圆柱体中分别给予两种不同剂量的生长激素(第1组,0.2和0.7国际单位;第2组,0.02和2国际单位),在相对侧的两个圆柱体中仅给予赋形剂。第3组在两个圆柱体中仅给予赋形剂,在相对侧进行针刺(假手术)。每三天注射一次生长激素或赋形剂(安慰剂),共注射16天。
体重、肉芽组织重量以及Ⅲ型前胶原的羟脯氨酸和氨基末端前肽浓度。
肉芽组织重量和胶原沉积的剂量反应曲线呈向上凸形(方差分析,p值分别<0.001和<0.001)。0.2和0.7国际单位剂量的生长激素刺激肉芽组织形成,其均值分别比安慰剂处理的圆柱体(第3组)高出180%(95%置信区间(Cl)149%至210%)和174%(95%Cl 148%至200%)(p值分别<0.05和<0.01)。然而,0.2和2国际单位的剂量效果较差。第1组和第2组动物中的安慰剂圆柱体所含肉芽组织平均比第3组的圆柱体多157%(95%Cl 137%至177%),表明局部应用生长激素也有全身效应。
局部生长激素在伤口愈合中的临床应用可能因治疗间隔相对狭窄而变得复杂。