Voerman B J, Strack van Schijndel R J, de Boer H, Groeneveld A B, Nauta J P, van der Veen E A, Thijs L G
Department of Endocrinology, Free University Hospital, Amsterdam, The Netherlands.
J Crit Care. 1994 Sep;9(3):143-50. doi: 10.1016/0883-9441(94)90010-8.
The effects of recombinant human growth hormone (GH) on fuel utilization, mineral and fluid balance in critically ill patients were studied.
Twenty patients requiring mechanical ventilation and receiving standard parenteral nutrition were studied. GH 0.1 mg/kg/day (n = 10) or placebo (n = 10) was administered as continuous intravenous infusion for 3 days. Plasma mineral levels, urinary nitrogen, and mineral excretion were measured. Indirect calorimetry was used to calculate energy production rate and fuel utilization.
Insulin-like growth factor I concentrations increased: day 4 GH, 18.9 +/- 7.0 ng/mL; controls 11.6 +/- 3.2 ng/mL (P < .05). During GH administration, the nitrogen balance became zero, whereas it remained negative in controls (P = .03). Fuel utilization did not differ between the groups. Neither did oxygen consumption, carbon dioxide production, or the respiratory quotient (RQ). Nonprotein RQ showed a tendency to decrease in the GH group, whereas an increase was present in controls. Mineral balance improved in both groups. Phosphate balance improved by 250% in the GH group (P = .054).
GH administration in critically ill patients reduces nitrogen loss and improves phosphate retention but does not have an important effect on fuel utilization.
研究重组人生长激素（GH）对重症患者能量利用、矿物质及液体平衡的影响。
对20例需要机械通气并接受标准肠外营养的患者进行研究。给予0.1mg/kg/天的GH（n = 10）或安慰剂（n = 10）持续静脉输注3天。测定血浆矿物质水平、尿氮及矿物质排泄量。采用间接测热法计算能量产生率及能量利用情况。
胰岛素样生长因子I浓度升高：第4天，GH组为18.9±7.0ng/mL；对照组为11.6±3.2ng/mL（P <.05）。给予GH期间，氮平衡变为零，而对照组仍为负平衡（P =.03）。两组间能量利用无差异。耗氧量、二氧化碳产生量或呼吸商（RQ）也无差异。非蛋白RQ在GH组呈下降趋势，而在对照组呈上升趋势。两组矿物质平衡均有所改善。GH组磷酸盐平衡改善了250%（P =.054）。
对重症患者给予GH可减少氮丢失并改善磷酸盐潴留，但对能量利用无重要影响。
