摘要
目的初步探讨重组人生长激素(rhGH)对重度烧伤低龄患儿免疫功能的影响。方法2016年7月—2018年7月笔者单位收治符合入选标准的重度烧伤低龄患儿30例,按随机数字表法分为rhGH组[15例,男10例、女5例,年龄(22±10)个月]、对照组[15例,男8例、女7例,年龄(21±7)个月],行前瞻性随机双盲对照试验。对照组患儿入院后行抗休克、抗感染、创面护理等治疗。rhGH组患儿在上述治疗基础上,伤后第3天开始皮下注射rhGH 0.2 IU·kg^-1·d^-1,每晚睡前1次,连续治疗7 d。rhGH治疗前及治疗3、7 d,分别抽取2组患儿空腹外周静脉血,采用血糖仪检测血糖水平,流式细胞仪检测CD4+T淋巴细胞比例、CD8+T淋巴细胞比例、CD4+/CD8+T淋巴细胞比值、CD3+T淋巴细胞比例、CD19+B淋巴细胞比例,酶联免疫吸附测定法检测血清IgA、IgG、补体C3质量浓度。对数据行Fisher确切概率法检验、独立样本t检验、重复测量方差分析并行Bonferroni校正、Mann-Whitney U检验。结果(1)2组患儿rhGH治疗前及治疗3、7 d血糖水平均相近(t=0.474、1.652、1.997,P>0.05)。rhGH组患儿rhGH治疗3、7 d血糖水平[(6.9±1.0)、(7.7±1.1)mmol/L]均明显高于rhGH治疗前[(5.9±0.9)mmol/L,P<0.05]。对照组患儿rhGH治疗7 d血糖水平明显高于rhGH治疗前(P<0.05)。(2)rhGH组患儿rhGH治疗前、治疗3 d CD4+T淋巴细胞比例为(35.1±2.0)%、(38.5±2.2)%,分别与对照组的(36.2±2.0)%、(33.6±2.2)%相近(t=0.371、1.553,P>0.05);rhGH组患儿rhGH治疗7 d CD4+T淋巴细胞比例[(44.7±2.2)%]明显高于对照组[(36.5±2.2)%,t=2.624,P<0.05]。rhGH组患儿rhGH治疗7 d CD4+T淋巴细胞比例明显高于rhGH治疗前(P<0.05),对照组患儿rhGH治疗3、7 d CD4+T淋巴细胞比例均与rhGH治疗前相近(P>0.05)。(3)rhGH组患儿rhGH治疗3 d CD8+T淋巴细胞比例明显低于对照组(t=2.107,P<0.05)。(4)rhGH组患儿rhGH治疗7 d CD4+/CD8+T淋巴细胞比值(2.36±0.20)明显高于对照组(1.72±0.20,t=2.285,P<0.05),rhGH组�
Objective To preliminarily investigate the influence of recombinant human growth hormone (rhGH) on the immune function of younger children with severe burn injuries. Methods A total of 30 younger children with severe burn injuries, conforming to the study criteria, were admitted to our hospital from July 2016 to July 2018. They were enrolled in the prospective, randomized, double-blinded, controlled trial and divided into group rhGH [n=15, 10 boys and 5 girls, aged (22±10) months] and control group [n=15, 8 boys and 7 girls, aged (21±7) months] according to the random number table. The patients in control group received anti-shock, anti-infection, and wound caring therapies, etc. On the basis of above-mentioned treatment, the patients in group rhGH were subcutaneously injected with rhGH once every night before bedding, with a dosage of 0.2 IU·kg-1·d-1, from the 3rd day post injury for 7 consecutive days. Before and on the 3rd and 7th day of rhGH treatments, the fasting peripheral venous blood was collected from patients in both groups. Blood glucose level was detected by glucometer. Percentages of CD4+ T lymphocytes, CD8+ T lymphocytes, CD3+ T lymphocytes, CD19+ B lymphocytes, and ratio of CD4+ T lymphocytes to CD8+ T lymphocytes were determined by flow cytometer. Mass concentration of serum immune globulin (Ig) A, IgG, and complement C3 were detected by enzyme-linked immunosorbent assay. Data were processed with Fisher′s exact probability test, independent sample t test, analysis of variance for repeated measurement and Bonferroni correction, and Mann-Whitney U test. Results (1) The blood glucose levels of children in the two groups were similar before and on the 3rd and 7th day of rhGH treatment (t=0.474, 1.652, 1.997, P>0.05). The glucose levels of children in group rhGH on the 3rd and 7th day of rhGH treatment [(6.9±1.0) and (7.7±1.1) mmol/L] were significantly higher than (5.9±0.9) mmol/L before rhGH treatment (P<0.05). The glucose level of children in control group on the 7th day of rhGH treatment
作者
梅爱莲
邱林
张标
袁心刚
刘燕
李天武
丁雄辉
Mei Ailian;Qiu Lin;Zhang Yue;Yuan Xingang;Liu Yan;Li Tianwu;Ding Xionghui(Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Reasearch Centerfor Child Health and Disorders,China International Science and Technology Cooperation Base of Child Developmentand Critical Disorders,Chongqing Key Laboratory of Pediatrics,Department of Burns and Plastic Surgery,Children's Hospital of Chongqing Medical University,Chongqing 400014,China)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2019年第10期726-732,共7页
Chinese Journal of Burns
基金
重庆市卫生和计划生育委员会2016年医学科研计划(2016MSXM044)
重庆医科大学附属儿童医院2015年度临床研究项目(lcyj2015-ll).
关键词
烧伤
免疫调节
生长激素
Bums
Immunomodulation
Growth hormone
