Frequent intravenous pulses of growth hormone together with glutamine supplementation in prolonged critical illness after multiple trauma: Effects on nitrogen balance, insulin resistance, and substrate oxidation
Frequent intravenous pulses of growth hormone together with glutamine supplementation in prolonged critical illness after multiple trauma: Effects on nitrogen balance, insulin resistance, and substrate oxidation
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DOI：
10.1097/ccm.0b013e318174d499
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发表时间：
2008-06-01
影响因子：
8.8
通讯作者：
Pachl, Jan
中科院分区：
文献类型：
--
作者：
Duska, Frantisek;Fric, Michal;Pachl, Jan
目的：评估生长激素替代疗法作为静脉脉冲、丙氨酰谷氨酰胺补充和严格血糖控制对长期危重疾病的疗效和代谢影响。设计：开放标签对照组的前瞻性双盲随机试验。地点：三级医院的重症监护病房。患者：30 名多发性创伤患者（中位损伤严重程度评分 34）。干预措施：患者在创伤后第 4 天被随机分配接受静脉注射补充丙氨酰谷氨酰胺（第 4 天至第 17 天为 0.3 g/kg.day(-1)）和静脉注射生长激素（第 7-17 天给药，从第 10 天起全剂量 50 μg/kg.day(-1)）（第 1 组，n = 10）或丙氨酰谷氨酰胺和安慰剂（第 2 组，n = 10）。第 3 组 (n 10) 接受不含丙氨酰谷氨酰胺的等热量等氮营养（蛋白质 1.5 g/kg.day(-1)）。测量和主要结果：整个研究期间的累积氮平衡为第 1 组 -97 +/- 38 克氮，第 2 组为 -193 +/- 50 克氮，第 3 组为 -198 +/- 77 克氮（p
Objectives: To estimate the efficacy and metabolic effects of growth hormone substitution as intravenous pulses together with alanyl-glutamine supplementation and tight blood glucose control in prolonged critical illness.Design: Prospective double-blind, randomized trial with open-label control arm.Setting: Intensive care unit of tertiary level hospital.Patients: Thirty multiple trauma patients (median Injury Severity Score 34).Interventions: Patients were randomized, at day 4 after trauma, to receive intravenous alanyl-glutamine supplementation (0.3 g/kg.day(-1) from day 4 until day 17) and intravenous growth hormone (administered days 7-17, full dose 50 mu g/kg.day(-1) from day 10 onward) (group 1, n = 10) or alanyl-glutamine and placebo (group 2, n = 10). Group 3 (n 10) received isocaloric isonitrogenous nutrition (proteins 1.5 g/kg.day(-1)) without alanyl-glutamine.Measurements and Main Results: Cumulative nitrogen balance for the whole study period was -97 +/- 38 g of nitrogen for group 1, -193 +/- 50 g of nitrogen for group 2, and -198 +/- 77 g of nitrogen for group 3 (p