OBJECTIVETo explore the effects of recombinant human growth hormone (rhGH) on postuburn hypermetabolism in burn patients and its mechanism.

METHODSThirty-two patients inflicted with burn of 50% to 90% TBSA admitted to our department during past 5 years (1998-2002) were enrolled in the study and randomly divided into A (with 0.25 U.kg(-1).d(-1) of rhGH treatment on 7-10 PBD, n=16) and B (with 0.25 U.kg(-1).d(-1) of normal saline as control, n = 16) groups. The changes in the rest energy expenditure (REE), non-protein respiratory quotient (NPRQ), glucose metabolism, nitrogen balance as well as plasma levels of endocrines and inflammatory mediators were determined before and after the administration of rhGH.

RESULTSrhGH was given to patients in group A during 7 - 10 PBD. The NPRQ in group A began to increase at the 7th PBD, raised to 0.80 +/- 0.09 in the 21st PBD. The plasma levels of PGE2, TXB2, TNF-alpha and IL-6 significantly decreased and insulin, rhGH and IGF-1 obviously increased when compared with those in group B. The accumulated nitrogen loss in group A was also much lower than that in group B. The plasma levels of adrenaline, cortisol, glucagon in group A were significantly higher than those in group B (P < 0.05).

CONCLUSIONThe postburn administration of rhGH timely could regulate postburn hypermetabolism in severely burned patients by increasing the plasma levels of GH, IGF-1 and insulin, which was beneficial to the improvement of nutrition state and to the promotion of protein synthesis and wound healing.