The Impact Of Pretreatment Of Recombinant Human Growth Hormone On Protein Metabolism, Muscle Function, Intestinal Barrier Function And Cell Immune Function

Objective: 1. To determine if the positive nitrogen balance could be achieved early by the pretreatment of rHGH. 2. To evaluate the effects of rHGH on intestinal permeability, intestinal morphology and cell immune function.Methods: A placebo-controlled randomized double-blind trial were performed. 20 patients undergoing abdominal surgery were randomized into two groups. The patients in the study group received rHGH (0.3IU/kg/day) subcutaneously from the 3^rd day before operation onward to the 7th day after operation. The patients in the control group received placebo. All the patients were given isonitrogenic (0.15g N/kg/day) and isocaloric (20 Kcal/kg/day) parenteral nutrition from the 1^st preoperative day to the 6^th postoperative day. Nitrogen balance and cumulative nitrogen balance were calculated during the 6 postoperative days. The body weight, hands grip strength, and the time requested to walk 20 meters were evaluated, the plasma glutamine level, peripheral CD4+/CD8+ lymphocyte proportion, blood routine and biochemistry analysis, intestinal permeability were determined before and after rHGH treatment. The jejunum biopsy was performed on the operation day for the determination of the intestinal morphology.Results: 1)The positive nitrogen balance was achieved from the 2^nd postoperative day onward with the pretreatment of rHGH, whereas the negative nitrogen balance lasted during the postoperative 6 days in the control group. The cumulative nitrogen balance in the study group was significantly better than that in the control group (P<0.01). 2) In the control group, body weigh, hands grip strength decreased, and the time requested to walk 20 meters increased significantly compared to the preoperative level (P<0.05). In the study group, there were no significant changes on postoperative 7^th day (P>0.05). The changes between the two groups were different significantly (P<0.05). 3) GH and IGF-1 levels were similar in the two groups and had not changed significantly in the control group by the 7^th postoperative day. In the study group a significant increase in serum levels of GH and IGF-1 was observed on 3^rd and 7^th postoperative day. 4) The plasma glutamine level in control group decreased on POD+7 compared to...