• 1. 昆明醫(yī)學(xué)院第二附屬醫(yī)院普外科(昆明650101)2. 云南大理洲醫(yī)院普外科;

為探討重組人生長激素(rhGH)對胃結(jié)腸癌患者術(shù)后蛋白分解代謝的影響，以及使用rhGH后能否改善腫瘤患者的免疫功能，減輕術(shù)后疲勞綜合征(POF)，將38例行根治性切除并經(jīng)病理學(xué)證實(shí)的腫瘤患者(胃癌21例，結(jié)腸癌17例)分為對照組(n＝18)和rhGH治療組(n＝20)，兩組患者術(shù)后均給予早期腹腔聯(lián)合灌注化療和經(jīng)中心靜脈施行的全胃腸外營養(yǎng)(total parenteral nutrition,TPN)支持，rhGH組術(shù)后第1～6天9∶30 am皮下注射8 U rhGH。結(jié)果：對照組術(shù)后第5、10天的血清白蛋白、前白蛋白、轉(zhuǎn)鐵蛋白和IgG、IgA、IgM、CD＋３、CD＋4及CD＋8水平均較術(shù)前明顯下降(Ｐ＜0.01)； rhGH治療組CD＋３、CD＋4及CD＋8水平術(shù)后第10天較術(shù)前明顯升高(Ｐ＜0.01)，其余變化無統(tǒng)計(jì)學(xué)意義； 精神狀態(tài)明顯好于對照組。術(shù)后第10天，對照組患者體重下降3～5 kg，rhGH組下降1～2 kg(Ｐ＜0.01)。實(shí)驗(yàn)結(jié)果提示： 腫瘤患者在術(shù)后早期腹腔聯(lián)合灌注化療和TPN營養(yǎng)支持的前提下應(yīng)用重組人生長激素，能通過增加蛋白合成以克服術(shù)后應(yīng)激反應(yīng)的蛋白分解代謝作用，改善宿主的免疫功能，減輕POF，有助于增強(qiáng)化療對腫瘤細(xì)胞的殺傷作用，提高患者對化療的耐受性。

引用本文： 陳嘉勇,張捷,譚晶,甘平,孫敏,陳雄志. 胃、結(jié)腸癌患者術(shù)后生長激素應(yīng)用的價(jià)值評估. 中國普外基礎(chǔ)與臨床雜志, 1999, 6(6): 365-367. doi: 復(fù)制

1. Stress ST, Beddoe AH, Hill GT, et al. Aggressive nutritional support does not prevent protein loss depise fat gain septic intensive care patient. J Trauma, 1987; 27(3)∶262.
2. Phillips LS. Nutrition, somatomedins and the brain. metabolism, 1986; 35(8)∶78.
3. Wilmore DW, Moylan JA, Bristow BF, et al. Anabolic effects of human growth hormone and high caloric feeding following thermal injury. Surg Gynecol Obstet, 1974; 138(6)∶87.
4. Lesniak NA, Roth J, Gorden P, et al. Human growth hormone radeoreceptor assay using cultured human lymphocytes. Nature (New Biol), 1973; 241(3)∶20.
5. Rapaport R, Sills IN, Green L, et al. Detection of human growth hormone receptors on IM9 cell s and peripheral blood mononuclear cell subsets by flow cytometry: correlation with growth hormonebinding protein levels. J Clin Endocrinol Metab, 1995; 80(9)∶2612.
6. Gelato MC. Growth hormoneinsulinlike growth factor I and immuune function. Trends Endocrinol Metab, 1993; 4(6)∶106.
7. Bozzola M, Valtorta A, Moretta A, et al. In vitro and in vivo effect of growth hormone on cytotoxic activity. J Pediatr, 1990; 117(4)∶596.
8. Lee PD, Pivarnik JM, Bukar JG, et al. A randomized, placebocontrolled trial of combined insulinlike growth factor I and low dose growth homone for wasting associated with human immunodeficiency virus infection. J Clin Endocrinol Metab, 1996; 81(8)∶2968.
9. VaraThorbeck TR, RuizRequena E, Guerrero JA. Effects of human growth hormone on the catabolic state after surgical trauma. Horm Res, 1964; 45(6)∶55.
10. Christensen T, Kehlet H. Postoperative fatigue. World J Surg, 1993; 17(2)∶220.
11. Schroeder D, Hill GL. Predicting postoperative fatigue, importance of preoperative factors. World J Surg, 1993; 17(2)∶226.
12. Ogilvy Stuart AL, Shalet SM. Tumor occurrence and recurrence. Hmor Res, 1992; 38(Suppl 1)∶50.
13. 任建安， 姜軍， 顧軍等. 營養(yǎng)支持加用生長抑素、生長激素促進(jìn)腸外瘺快速愈合. 腸內(nèi)與腸外營養(yǎng)， 1998； 3(5)∶125.
  1. 1. Stress ST, Beddoe AH, Hill GT, et al. Aggressive nutritional support does not prevent protein loss depise fat gain septic intensive care patient. J Trauma, 1987; 27(3)∶262.
  2. 2. Phillips LS. Nutrition, somatomedins and the brain. metabolism, 1986; 35(8)∶78.
  3. 3. Wilmore DW, Moylan JA, Bristow BF, et al. Anabolic effects of human growth hormone and high caloric feeding following thermal injury. Surg Gynecol Obstet, 1974; 138(6)∶87.
  4. 4. Lesniak NA, Roth J, Gorden P, et al. Human growth hormone radeoreceptor assay using cultured human lymphocytes. Nature (New Biol), 1973; 241(3)∶20.
  5. 5. Rapaport R, Sills IN, Green L, et al. Detection of human growth hormone receptors on IM9 cell s and peripheral blood mononuclear cell subsets by flow cytometry: correlation with growth hormonebinding protein levels. J Clin Endocrinol Metab, 1995; 80(9)∶2612.
  6. 6. Gelato MC. Growth hormoneinsulinlike growth factor I and immuune function. Trends Endocrinol Metab, 1993; 4(6)∶106.
  7. 7. Bozzola M, Valtorta A, Moretta A, et al. In vitro and in vivo effect of growth hormone on cytotoxic activity. J Pediatr, 1990; 117(4)∶596.
  8. 8. Lee PD, Pivarnik JM, Bukar JG, et al. A randomized, placebocontrolled trial of combined insulinlike growth factor I and low dose growth homone for wasting associated with human immunodeficiency virus infection. J Clin Endocrinol Metab, 1996; 81(8)∶2968.
  9. 9. VaraThorbeck TR, RuizRequena E, Guerrero JA. Effects of human growth hormone on the catabolic state after surgical trauma. Horm Res, 1964; 45(6)∶55.
  10. 10. Christensen T, Kehlet H. Postoperative fatigue. World J Surg, 1993; 17(2)∶220.
  11. 11. Schroeder D, Hill GL. Predicting postoperative fatigue, importance of preoperative factors. World J Surg, 1993; 17(2)∶226.
  12. 12. Ogilvy Stuart AL, Shalet SM. Tumor occurrence and recurrence. Hmor Res, 1992; 38(Suppl 1)∶50.
  13. 13. 任建安， 姜軍， 顧軍等. 營養(yǎng)支持加用生長抑素、生長激素促進(jìn)腸外瘺快速愈合. 腸內(nèi)與腸外營養(yǎng)， 1998； 3(5)∶125.