The Effect Of RhGH-combined EN On Protein Metabolism And Immune Function In Patients Post Operation Liver Cirrhosis Portal Hypertension

Background GH is hypothalamus antehypophysis somatotroph secretary a kind of peptide hormone, contain 191 pieces amino acids single strand polypeptide, Mankind postnatal promote vegetative super hormone, have species-specificity. Earlier period principal use to treat children GHD, later in the empyrosis patients,renal failure olialyse patients obviously promote protein synthesis to use GH ,to quicken recovered. In ICU using breathing machine patients strengthen respiratory muscle power to use GH, boost off-line achievement ratio. To show obviously promote anabolic action, simultaneously reinforce organism immune function, lower complication incidence rate. For approach rhGH-combined EN to treat liver cirrhosis portal hypertension patients validity and feasibility, on the animal experiment we make comparison clinical test, purpose to explore post operation liver cirrhosis portal hypertension patients clinical treatment new method, and expound applied possible effect pathway.Objective To approach the effect of rhGH-combined EN on nutrition state and immune function in patients post operation liver cirrhosis portal hypertension, and analysis possible mechanism.Methods Apply prospective,contrast,open clinical research. To accord with selecting conditional 60 patients divided two groups: simple enteral nutrition group (EN) 30patients, enteral nutrition +growth hormone group (EN+GH) 30patients. Two groups patients other base treatment alike. The two groups all started nutritional support from the post operation first day, post operation intake calory 146.3KJ/kgï¹’d(35kcal/kgï¹’d),nitogen 0.2g/kgï¹’d,nonprotein-calorine : nitrogen =140: 1 . Post operation the first day intake standard quantitative 1/3, post operation the second day intake standard quantitative 1/2, post operation the third day intake standard quantitative full dose, adopt infusion pump uniformity infusion. At the same time the GH+EN group started rhGH 8IU subcutaneous injection, continuous used to 7 days, The EN group injected equal volume placebo at the same time and position. At before operation 1 day and post operation 1,4,7,10 days take suction PV venous blood. To monitoring GH,IGF-1,IGFBP3,TP,ALB,TF,PA and CD3+,CD4+,CD8+,IgG,IgM,IgA levels. Meanwhile collected two groups post operation 1,4,7,10 days 24 hours urine volume, determined nitrogen balance.Results Two groups patients post operation TP,ALB,TF,PA all cut down compare to preoperative, The GH+EN group post operation 4,7,10 days TF,PA set up obviously, p<0.05.Post operation 7,10 days the GH+EN group TP,ALB set up obviously to compare the EN group, p<0.05; The GH+EN group post operation 4 day recover ortho-nitrogen balance, But the EN group still to remain negative nitrogen balance, difference have signification, p<0.05;Post operation 4,7,10 days the GH+EN group IGF-1 IGFBP3 set up obviously compare to the EN , difference have signification, p<0.05;Post operation 1 day CD3+,CD4+,CD4+/CD8+ all cut down compare to preoperative, post operation 7,10 days the GH+EN group set up obviously compare to the EN group, p<0.05 or p<0.01; But CD8+ set up obviously in the EN group post operation, p<0.05; Two groups post operation 1 day IgG,IgM,IgA cut down obviously compare to preoperative, Post operation 7,10 days the GH+EN group set up obviously, p<0.05 or p<0.01.Conclusions: rhGH-combined EN supportive treatment patients post operation liver cirrhosis portal hypertension, obviously improve GH counteracting phenomenon, to deteriorate organism high metabolism and negative nitrogen balance, promoted protein synthesis, to improve Hypoproteinemia. Meanwhile protect organism bowels mucous membrane barricade, boost immune function, to lower complications development.