Ghrelin Administration for Chronic Respiratory Failure: A Randomized Dose-Comparison Trial. Lung
Ghrelin Administration for Chronic Respiratory Failure: A Randomized Dose-Comparison Trial. Lung
复制标题
生长素释放肽治疗慢性呼吸衰竭：随机剂量比较试验。
作者：
Matsumoto N;Miki K;Tsubouchi H;Sakamoto A;Arimura Y;Yanagi S;Iiboshi H;Yoshida M;Souma R;Ishimoto H;Yamamoto Y;Yatera K;Yoshikawa M;Sagara H;Iwanaga T;Mukae H;Maekura R;Kimura H;Nakazato M;Kangawa K
背景：反复给予ghrelin可改善肺病恶病质患者的症状、肌肉萎缩和运动耐量。我们调查了最佳的ghrelin剂量为体重不足的慢性呼吸衰竭患者慢性respiratory failure.MethodsIn这个多中心，随机，剂量比较探索性研究，44恶病质慢性呼吸衰竭患者随机分配肺康复与静脉注射1或2 μg/kg的ghrelin，每天两次，为期3周。主要终点是6分钟步行距离（6 MWD）的改善。次要终点是峰值O2的变化。结果21例患者被分配到1 μg/kg ghrelin组和23例患者被分配到2 μg/kg ghrelin组。治疗后6 MWD较基线的变化在组间相似（1 μg/kg：53.9 m，2 μg/kg：53.9 m，p= 0.99）。2 μg/kg组的峰值O2平均变化（63.1 ml/min）显著大于1 μg/kg组（−63.8 ml/min，p= 0.048）。两组的摄食量和瘦体重均显著增加，仅2 μg/kg组的圣乔治呼吸问卷评分、体重和体重指数显著改善，但组间无显著差异。没有治疗相关的严重事件被报道为任一group. ConclusionImprovement的摄氧量的能力更大的患者接受2 μg/kg的ghrelin每天两次，持续3周比那些接受1 μg/kg，虽然运动耐量是相似的组之间在3周的治疗期结束。因此，对于患有慢性呼吸衰竭和体重减轻的患者，推荐2 μg/kg生长素释放肽的每日两次剂量超过1 μg/kg生长素释放肽。
BackgroundRepeated ghrelin administration leads to improvements in symptoms, muscle wasting and exercise tolerance in cachectic patients with pulmonary disease. We investigated the optimal ghrelin dose for underweight patients with chronic respiratory failure.MethodsIn this multicenter, randomized, dose-comparison exploratory study, 44 cachectic patients with chronic respiratory failure were randomly assigned pulmonary rehabilitation with intravenous twice-daily administration of 1 or 2 μg/kg ghrelin for 3 weeks. The primary endpoint was improvement in 6-min walking distance (6MWD). The secondary endpoint was change in peakO2.ResultsTwenty-one patients were assigned to the 1 μg/kg ghrelin group and 23 to the 2 μg/kg ghrelin group. Change from baseline 6MWD after treatment was similar between groups(1 μg/kg: 53.9 m, 2 μg/kg: 53.9 m,p= 0.99). Mean change in peakO2was significantly greater in the 2 μg/kg group (63.1 ml/min) than in the 1 μg/kg group (−63.8 ml/min,p= 0.048). Food intake and lean body mass significantly increased in both groups, and the St. George Respiratory Questionnaire score, body weight, and body mass index were remarkably improved in only the 2 μg/kg group, although there was no significant difference between groups. No treatment-related serious events were reported for either group.ConclusionImprovements in the oxygen uptake capacity were greater in patients receiving 2 μg/kg ghrelin twice daily for 3 weeks than in those receiving 1 μg/kg, although exercise tolerance was similar between groups at the end of the 3-week treatment period. Thus, a twice daily dose of 2 μg/kg ghrelin is recommended over 1 μg/kg ghrelin for patients with chronic respiratory failure and weight loss.