Clinical Outcomes in Rehabilitated Burn Children

这项提议将检验这样一种假设，即锻炼计划和每天给予重组人生长激素将促进严重烧伤后儿童完全恢复生理功能。将进行一项干预性研究，其中临床相关结果参数将在烧伤后每隔3个月至一年进行量化。一半的患者将随机接受全年0.05 mg/kg/d的重组人生长激素或安慰剂注射。每组都将被进一步随机分为两组，一组参加施林纳烧伤医院提供的为期3个月的运动调理计划，另一组接受标准的家庭康复。因此，4组患者将在烧伤后一年内接受研究。研究的终点将是膝关节高度和站立高度、体重、40K计数器和双能X射线吸收测量仪(DEXA)测定的瘦体重、肌肉强度、骨密度、骨组织形态测量和温哥华疤痕分级法测定的疤痕形成。第三、第四和第七型胶原的鉴定和定量也将从皮肤活检中进行。

This proposal will test the hypothesis that an exercise program and the daily administration of recombinant human growth hormone will promote recovery to full physiological function in children after severe burn injury. An intervention study will be performed in which clinically relevant outcome parameters will be quantified at 3-month intervals up to one year post-burn. Half of the patients will be randomized to receive 0.05 mg/kg/d of recombinant human growth hormone or placebo injection throughout the year. Each group will be further randomized to participate in a 3-month exercise-conditioning program offered at the Shriners Burns Hospital, or receive standard home rehabilitation. Thus, 4 groups of patients will be studied up to one year post-burn. Endpoints of this study will be knee heights and standing height, body weight, lean body mass determined by 40K-counter and dual energy x-ray absorptiometry (DEXA), muscle strength, bone density, bone histomorphometry, and scar formation by the Vancouver Scar Scale. Identification and quantitation of types III, IV, and VII collagen will also be made from skin biopsies.