Study Of The Assessment On The Nutritional Status And The Level Of Cerebral Energy Metabolism Material In COPD Patients Influence Of Recombinant Human Growth Hormone On The Nutritional Status And Immune Function In COPD Patients

[Objective]To investigate the effects of recombinant human growth hormone(r-hGH) on theNutritional status,immune function and protein metabolism in COPD.To assess the Thigh muscle Cross sectional area in COPD patients through themagnetic resonance imaging and discuss the relationship between Thigh muscle Crosssectional area and BMI.To assess the level of cerebral energy metabolism material in COPD patientsthrough the hydrogen proton magnetic resonance spectroscopy examination anddiscuss the relationship between the cerebral energy metabolism material andFEV1%pred.[Methods]1.28patients with moderate and several AECOPD who received standardnutritiona1support were enrolled as control group A;32patients with moderate andseveral AECOPD who receivedstandard nutritional support and r-hGH were includedas group B. All subjects received anti-infection therapy,phlegm-expellingformula,brochodilators.The levels of ALB,TRF,PA,creatinine,urea,IgA,IgM,IgG wereobserved before and the2th day after treatment. Moreover,the variables includingT-cell subsets,such as CD3+,CD4+,CD4+/CD8+.2.15cases of COPD patients and11cases of age, gender, height, body quality,body mass index-matched were taken MRI examination, to assess thigh muscle crosssectional area of COPD patients through the magnetic resonance imaging,and discussthe relationship between thigh muscle cross sectional area and BMI.3.15cases of AECOPD patients and12cases of age-matched were taken1H-MRSexamination, to assess integral value of NAA,Cho Cr,NAA/Cr and Cho/Cr ofparieto-temporal and occipital areas of the brain, and discuss the relationship between the cerebral energy metabolism material and FEV1%pred.[Results]1. There are only54cases because of3lost cases in both Group B and Group A. So we have used the intention to treat analysis to analyse the data.Compared with gourp A,subjects in group B had a increase in ALB,TRF,PA,creatinine,urea,IgA,IgM,and IgG(P<0.05),the T-cell subsets,such as CD3+,CD4+,CD4+/CD8+were observably higher in group B.2.(1)30%level of the MRI images:the thigh muscle cross sectional areas of quadriceps femoris,hamstring and adductor in COPD group (35.49±4.29;3.66±0.72;35.35±4.77) were lower than those in control group (44.62±3.0;4.46±0.83;45.02±3.33),P<0.05.(2)60%level of the MRI images:the thigh muscle cross sectional areas of quadriceps femoris and adductor in COPD group(42.49±4.47,33.8±6.13) were lower than those in control group (50.9±3.52,42.57±4.79),P<0.05. the hamstring cross sectional ares of COPD group and control group showed no significant difference, P>0.05.(3)90%level of the MRI images:the thigh muscle cross sectional areas of quadriceps femoris and hamstring in COPD group (26.05±4.34;21.39±4.06) were lower than those in health control group (34.98±5.24;27.32±4.55),P<0.05. the adductor cross sectional ares of COPD group and control group showed no significant difference, P>0.05.(4) the thigh muscle cross sectional areas of quadriceps femoris at30%,60%,90%level of the MRI images have a positive correlation relationship with BMI,and the thigh muscle cross sectional areas of adductor at60%level of the MRI images have a positive correlation relationship with BMI in COPD group.3、(1) NAA, Cho, Cr and NAA/Cr of occipital areas of the brain in AECOPD group (8.86±3.30;4.85±1.49;5.83±1.99;1.52±0.15) were lower than those in control group (13.74±4.70;7.59±2.42;8.44±3.03;1.65±0.17), P<0.05.(2) NAA, Cr and NAA/Cr of parieto-temporal areas of the brain in AECOPD group (8.78±3.36;6.56±2.12;1.32±0.18) were lower than those in control group (13.44±3.06;8.75±1.07;1.53±0.20), P<0.05.(3) The Cho/Cr of occipital areas of the brain in AECOPD group and control group showed no significant difference, P>0.05.(4) Cho,Cho/Cr of parieto-temporal areas of the brain in AECOPD group and control group showed no significant difference, P>0.05.(5) The NAA,Cho,NAA/Cr of occipital areas and the NAA/Cr of parieto-temporal areas of brain in AECOPD group have a correlation relationship with FEV1%pred.[Conclusions]1.The r-hGH could induce better the Nutritional status,immune function and Protein metabolism in moderate and several COPD.2.The thigh muscle cross sectional areas in COPD group were lower than those in control group and some of them have a correlation relationship with BMI.3、The concentration of cerebral metabolite in COPD group were lower than those in control group,some of the cerebral energy metabolism material have a correlation relationship with FEV1%pred.