摘要
目的探讨添加生长激素(growth hormone,GH)肠外营养对外科重症患者骨骼肌降解的影响。方法将20名外科重症患者随机分为肠外营养(parenteral nutrition,PN)组及添加GH的肠外营养组(PN+GH)。在营养治疗前及后第5、8天采用高效液相色谱法(HPLC)测定患者24 h尿中 3-甲基组氨酸(3-MH)的排出量;在第8天做股四头肌活检,用免疫组化法检测泛素蛋白表达,核糖核酸印迹法检测泛素及C2亚基mRNA表达,电子显微镜观察骨骼肌超微结构的变化。结果 GH组患者尿中3-MH含量以及股四头肌泛素蛋白、泛素和C2亚基mRNA的表达较PN组均明显降低(t= 4．886,6．846,7．314,5．588,P<0．01),骨骼肌肌小节完整,核糖体丰富。结论GH可以抑制外科重症患者骨骼肌的降解,在mRNA水平下调泛素及C2亚基的基因表达,改善骨骼肌细胞的超微结构。
Objective To study the effect of growth hormone （GH） combined with parenteral nutrition on skeletal muscle proteolysis for surgical critical patients. Methods Twenty surgical patients with APACHE Ⅱ scores from 10 to 20 were divided randomly into two groups： parenteral nutrition group （PN group,n = 10） ; PN ＋GH （GH group,n = 10）. At the 5th day and 8th day during the study, urinary output of 3-methylhistidine （3-MH） in 24 h urine were assessed with high performance liquid chromatography; at the 8th day the protein expressions of ubiquitin in quadriceps femoris muscle were determined by immunohistochemistry and the expressions of ubiquitin and C2 mRNA were determined by Northern blot analysis, the uhrastrueture of quadriceps femoris muscle was observed under electronic microscope. All data were collected down in the form as mean ± standard deviation and analyzed with SPSS 11.5 for Windows. Results The urine level of 3-MH and the protein, mRNA and C, mRNA expression of ubiquitin in quadriceps femoris muscle decreased in GH group as compared with PN group （ t = 4. 886, 6. 846,7. 314,5. 588,P 〈0. 01 ）. The injured degree of muscular fibers in GH group was less than PN group. Conclusion The application of GH in surgical critical patients decreases muscle protein degradation possibly by decreasing the expression of ubiquitin system.
出处
《中华普通外科杂志》
CSCD
北大核心
2006年第1期35-37,共3页
Chinese Journal of General Surgery
基金
上海市科技发展基金资助项目(024119039)
关键词
危重病人医疗
肠营养
生长激素
营养评价
蛋白降解
Critical care
Enteral nutrition
Somatropin
Nutrition assessment
Degradation of protein
作者简介
通信作者：秦环龙，E-mail：hlqin@sjtu．edu．cn
