title: Combined human growth hormone and lactulose for prevention and treatment of multiple organ dysfunction in patients with severe chronic hepatitis B.
abstract: OBJECTIVE
  To evaluate the efficiency and safety of combined recombinant human growth hormone (rhGH) and lactulose for treatment and/or prevention of multiple organ dysfunction in patients with chronic severe hepatitis B.
  
  
  METHODS
  Forty-eight inpatients with chronic severe hepatitis B were randomly divided into rhGH group (n=28) and control group (n=20). In rhGH group, 4-4.5 IU of rhGH was injected intramuscularly once daily for 2-4 wk, and 100 mL of enema containing 30 mL of lactulose, 2 g of metronidazole and 0.9% saline was administered every 2 d for 2-4 wk. Their symptoms and complications were noted. Liver and kidney functions were analyzed by an Olympus analyzer. Serum GH, IGF-1, IGFBP1 and IGFBP3 were measured by ELISA.
  
  
  RESULTS
  Clinical symptoms of 90% of these patients in rhGH group were obviously improved. The total effectiveness in rhGH group was better than that in control group (75% vs 40%, P<0.05). After 2- and 4-wk treatment of rhGH respectively, serum albumin (26.1+/-4.1 vs 30.2+/-5.3, 31.9+/-5.1 g/L), prealbumin (79.6+/-28.0 vs 106.6+/-54.4, 108.4+/-55.0 g/L), cholesterol (76.3+/-16.7 vs 85.6+/-32.3, 96.1+/-38.7 mg/dL), and IGFBP1 (56.8+/-47.2 vs 89.7+/-50.3 ng/mL after 2 wk) were significantly increased compared to control group (P<0.05). However, serum GH was decreased. The increase of serum IGF1 and IGFBP3 after rhGH treatment was also observed.
  
  
  CONCLUSIONS
  rhGH in combination with lactulose may be beneficial to the prevention and treatment of multiple organ dysfunction in patients with chronic severe hepatitis.
authors.affiliation: Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital University of Medical Sciences, Beijing 100054, China. dinghuiguo@medmail.com.cn
authors.forename: Hui-Guo
authors.initials: HG
authors.lastname: Ding
authors.forename: Jing
authors.initials: J
authors.lastname: Shan
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Ma
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Rui
authors.initials: R
authors.lastname: Jin
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Tan
authors.forename: Li-Xiang
authors.initials: LX
authors.lastname: He
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000150:complications*; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007792:Lactulose / Q000008:administration & dosage*; D008297:Male; D009102:Multiple Organ Failure / Q000188:drug therapy* / Q000517:prevention & control / Q000821:virology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D019382:Human Growth Hormone; D007792:Lactulose