[The effect of enteral nutritional support and growth hormone on critical patients].
OBJECTIVE
To explore the effect of early enteral nutritional support and growth hormone (GH) on critical patients.


METHODS
Sixty-eight critical patients were divided into enteral nutrition (EN) group and EN+GH group, with 34 patients in each group, by random number table. All the patients in both group received early enteral nutritional support, at the same time, the patients in EN+GH group received GH 5 U, once a day for 10 days. The intake was isonitrogenous and isocaloric in both groups. Body weight, blood biochemistry examination, nutrition state and lactulose/mannitol test were performed before and 5 days and 10 days after nutritional support. Immune function was performed after 10 days. Nitrogen balance was measured daily.


RESULTS
The changes in body weight, albumin and transferring levels were more obvious in the EN+GH group than those in the EN group before and 5 days and 10 days after nutritional support, but the difference was not significant between the two groups. On the 5th and 10th day after treatment, the level of prealbumin [the 5th day:(25.34+/-4.26) g/L vs. (20.62+/-3.58) g/L; the 10th day: (27.34+/-4.25) g/L vs. (23.87+/-2.96) g/L] and that of fibronectin [the 5th day: (2.68+/-0.37) mg/L vs. (2.01+/-0.27) mg/L; the 10th day: (2.74+/-0.31) mg/L vs. (2.44+/-0.19) mg/L] in the EN+GH group were significantly higher than those in the EN group (all P<0.05). However, the level of lactulose/mannitol was significantly lower in EN+GH group than that in the EN group (the 5th day: 0.065+/-0.004 vs. 0.087+/-0.005, the 10th day: 0.027+/-0.002 vs. 0.053+/-0.004, both P<0.01). On the 10th day after treatment, the level of IgA in the EN+GH group was significantly lower than that in the EN group [(2.10+/-0.09) g/L vs.(3.45+/-0.25) g/L], but the levels of CD3 (0.682+/-0.049 vs. 0.606+/-0.046), CD4 (0.456+/-0.039 vs. 0.372+/-0.032), CD4/CD8 ratio (1.66+/-0.11 vs. 1.41+/-0.12), and the natural killer cell (NK cell, 0.139+/-0.011 vs.0.107+/-0.004) in the EN+GH group were significantly higher than those in the EN group (all P<0.05). The gut barrier function in the EN+GH group was superior to that in the EN group during nutritional support period. Nitrogen balance was positive in the EN+GH group [(27.54+/-23.15) mg/kg] and negative in the EN group [-(5.13+/-4.26) mg/kg].


CONCLUSIONS
Early enteral nutritional support can improve state of nutrition, and it is combined with GH composition of protein may be improved and the immune function may be enhanced.
Zhou
Rui-Xiang
RX
Intensive Care Unit of the First Hospital of Wuhan, Wuhan 430022, Hubei, China. zhouxiang7312@sina.com
Weng
Fang-Zhong
FZ
Yan
Jun
J
Fan
Xue-Peng
XP
D000328:Adult; D000368:Aged; D016638:Critical Illness; D004750:Enteral Nutrition; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016896:Treatment Outcome
D019382:Human Growth Hormone