Demling R H, DeSanti L
Brigham and Women's Hospital Burn Center, Boston, Massachusetts 02115, USA.
J Trauma. 1997 Jul;43(1):47-51. doi: 10.1097/00005373-199707000-00012.
We studied the effect of an anabolic steroid, oxandrolone, combined with a high-protein diet (2 g/kg/day) on the rate of weight gain and restoration of muscle function in the recovery phase after deep burns of 30 of 50% of total body surface (n = 7). The findings were compared with findings from an isocaloric (2 g/kg/day protein) diet alone (n = 6). The study was prospective and randomized. Data were also compared retrospectively with data from a group of burn patients treated in the same fashion using a high-calorie, high-protein diet with a protein content of 1.3 to 1.4 g/kg/day (n = 10). Muscle function was quantified using a physical therapy index defining rate of progress (0 = lowest, 10 = highest). Oxandrolone was given in the beginning of the recovery phase in a dosage of 10 mg orally twice a day. The recovery phase was defined as resolution of the hypermetabolic state using physiologic criteria. The study was performed in an acute burn rehabilitation facility where patients were transferred once entering the recovery phase. Patients in each group were not different with regard to age and burn size. We found that mean weight loss for all patients was 11 +/- 2% of preburn weight during the catabolic phase despite optimum nutrition and early wound closure. Data are presented as mean +/- SD. We found that the average weight gain during the first 3 weeks was 14.5 +/- 2.5 pounds and that the physical therapy index was 8.8 +/- 0.5 of recovery in the oxandrolone-protein group (n = 7); both of these values were significantly greater than the corresponding values in the other groups. In the high-protein alone group (n = 6), weight gain was 7.5 +/- 1.7 pounds and physical therapy index was 7.0 +/- 0.8. In the retrospective group (n = 10), weight gain was 4.4 +/- 0.8 pounds and function index was 4.1 +/- 0.5. The daily caloric intake was not different between groups. Protein content and oxandrolone were the variables. No side effects were noted with oxandrolone. We can conclude that an anabolic steroid combined with increased protein intake can significantly increase the rate of restoration of weight gain postburn.
我们研究了合成代谢类固醇氧雄龙与高蛋白饮食（2克/千克/天）联合使用，对30%至50%体表面积深度烧伤后恢复阶段体重增加速率和肌肉功能恢复的影响（n = 7）。将研究结果与仅采用等热量（2克/千克/天蛋白质）饮食的结果进行比较（n = 6）。该研究为前瞻性随机研究。还将数据与一组采用1.3至1.4克/千克/天蛋白质含量的高热量、高蛋白饮食以相同方式治疗的烧伤患者的数据进行回顾性比较（n = 10）。使用定义进展速率的物理治疗指数对肌肉功能进行量化（0 = 最低，10 = 最高）。氧雄龙在恢复阶段开始时以每天口服两次、每次10毫克的剂量给药。恢复阶段根据生理标准定义为高代谢状态的消退。该研究在急性烧伤康复机构进行，患者一旦进入恢复阶段就被转移至此。每组患者在年龄和烧伤面积方面无差异。我们发现，尽管营养优化且伤口早期闭合，但在分解代谢阶段所有患者的平均体重减轻为烧伤前体重的11±２%。数据以平均值±标准差表示。我们发现，在氧雄龙 - 蛋白质组（n = 7）中，前3周的平均体重增加为14.5±2.5磅，物理治疗指数为恢复时的8.8±0.5；这两个值均显著高于其他组的相应值。在仅高蛋白组（n = 6）中，体重增加为7.5±1.7磅，物理治疗指数为7.0±0.8。在回顾性组（n = 10）中，体重增加为4.4±0.8磅，功能指数为4.1±0.5。各组之间的每日热量摄入无差异。蛋白质含量和氧雄龙为变量。未观察到氧雄龙的副作用。我们可以得出结论，合成代谢类固醇与增加蛋白质摄入量相结合可显著提高烧伤后体重恢复的速率。
