RESUMO
OBJECTIVE: To explore the effects of recombinant human growth hormone (rhGH) on postuburn hypermetabolism in burn patients and its mechanism. METHODS: Thirty-two patients inflicted with burn of 50% to 90% TBSA admitted to our department during past 5 years (1998-2002) were enrolled in the study and randomly divided into A (with 0.25 U.kg(-1).d(-1) of rhGH treatment on 7-10 PBD, n=16) and B (with 0.25 U.kg(-1).d(-1) of normal saline as control, n = 16) groups. The changes in the rest energy expenditure (REE), non-protein respiratory quotient (NPRQ), glucose metabolism, nitrogen balance as well as plasma levels of endocrines and inflammatory mediators were determined before and after the administration of rhGH. RESULTS: rhGH was given to patients in group A during 7 - 10 PBD. The NPRQ in group A began to increase at the 7th PBD, raised to 0.80 +/- 0.09 in the 21st PBD. The plasma levels of PGE2, TXB2, TNF-alpha and IL-6 significantly decreased and insulin, rhGH and IGF-1 obviously increased when compared with those in group B. The accumulated nitrogen loss in group A was also much lower than that in group B. The plasma levels of adrenaline, cortisol, glucagon in group A were significantly higher than those in group B (P < 0.05). CONCLUSION: The postburn administration of rhGH timely could regulate postburn hypermetabolism in severely burned patients by increasing the plasma levels of GH, IGF-1 and insulin, which was beneficial to the improvement of nutrition state and to the promotion of protein synthesis and wound healing.
