CAJ | 학술논문

目的观察不同年龄重度烧伤患者应用外源性生长激素的血糖变化.方法将140例既往无糖尿病史的不同年龄段重度烧伤患者根据世界卫生组织对年龄段的划分标准,分为A组(18～44岁,即青年组)和B组(≥45岁,即中、老年组),各70例.再采用表格随机法将A、B两组分成使用0.2 IU·kg-1·d-1生长激素的A1组、B1组和使用安慰剂(等渗盐水)的A0组、B0组,每组均35例.观察受试者血糖水平变化及胰岛素控制的用量,并进行分析探讨.结果 140例入组的患者共128例完成实验,各组之间一般情况差异无统计学意义(P＞0.05),在入院4周内完成试验,A1、A0两组胰岛素用量分别为(2 908.0±153.5)IU和(724.1±31.1)IU,B1、B0两组胰岛素用量分别为(3 725.9±88.4)IU和(801.8±22.2)IU.结果显示,中、老年组比青年组、使用生长激素组比不使用生长激素组需要胰岛素控制的例数多、用量大,差异均有统计学意义(P＜0.01).A1、B1组出现高血糖的患者停用生长激素后血糖恢复正常(不需要胰岛素控制)的时间分别为(5.21±0.64)d、(5.03±1.01)d(P＞0.05).结论重度烧伤患者应用生长激素后血糖水平升高,年龄与血糖变化呈正相关,规范应用生长激素治疗不会导致糖尿病.
목적 관찰불동년령중도소상환자응용외원성생장격소적혈당변화.방법 장140례기왕무당뇨병사적불동년령단중도소상환자근거세계위생조직대년령단적화분표준,분위A조(18～44세,즉청년조)화B조(≥45세,즉중、노년조),각70례.재채용표격수궤법장A、B량조분성사용0.2 IU·kg-1·d-1생장격소적A1조、B1조화사용안위제(등삼염수)적A0조、B0조,매조균35례.관찰수시자혈당수평변화급이도소공제적용량,병진행분석탐토.결과 140례입조적환자공128례완성실험,각조지간일반정황차이무통계학의의(P＞0.05),재입원4주내완성시험,A1、A0량조이도소용량분별위(2 908.0±153.5)IU화(724.1±31.1)IU,B1、B0량조이도소용량분별위(3 725.9±88.4)IU화(801.8±22.2)IU.결과 현시,중、노년조비청년조、사용생장격소조비불사용생장격소조수요이도소공제적례수다、용량대,차이균유통계학의의(P＜0.01).A1、B1조출현고혈당적환자정용생장격소후혈당회복정상(불수요이도소공제)적시간분별위(5.21±0.64)d、(5.03±1.01)d(P＞0.05).결론 중도소상환자응용생장격소후혈당수평승고,년령여혈당변화정정상관,규범응용생장격소치료불회도치당뇨병.
Objective To observe the changes of blood sugar following use of recombinant human growth hormone (rhGH) in patients with severe burn. Methods A total of 140 patients with severe burn but with no history of diabetes were randomly and equally divided into Group A ( 18-44 years old) and Group B ( ≥45 years old) according to WHO criteria. Then, two groups were randomly divided Group B0 (treated with normal saline), 35 patients per group. Change of blood sugar and amount of insuline for control of blood sugar were observed and analyzed. Results Of 140 patients in four groups,128 patients accomplished the test, with no statistical difference upon general conditions between groups (P ＞0.05 ). Within four weeks after test, the amount of insuline used for control of blood sugar was (2908.0 ± 153.5) IU and (724.1 ± 31.1 ) IU respectively in Groups A1 and A0, (3725.9 ± 88.4) IU and (801.8 ±22.2) IU respectively in Groups B1 and BO. The results showed that the patients needing insulin to control blood sugar in Group B were more than that in Group A ( P ＜ 0.01 ). The time for blood sugar recovering to normal range in patients with high blood sugar with no use of rhGH in Group A1 and Group B1 was (5.21 ±0.64) d and (5.03 ± 1.01) d respectively (P＞0.05). Conclusions The blood sugar of patients with severe burn will rise after use of rhGH. The age of the patients is positively correlated with changes of blood sugar. Standard use of rhGH does not induce diabetes.