Effects of recombinant human growth hormone on enterocutaneous fistula patients

AIM:To explore the effects of recombinant human growth hormone (rhGH) on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fi stula. METHODS:Eight patients with enterocutaneous fi stulas received recombinant human growth hormone (10 μg/d) for 7 d. Image analysis and immunohisto-chemical techniques were used to analyse the expression of proliferating cell nuclear antigen (PCNA) in intestinal mucosal epithelial cells in biopsy samples from the patients who had undergone an endoscopic biopsy through the fi stula at day 0,4 and 7. Body weights,nitrogen excretion,serum levels of total proteins,albumin,prealbumin,transferrin and fi bronectin were measured at day 0,4 and 7. RESULTS:Significant improvements occurred in the expression of PCNA in the intestinal mucosal epithelial cells at day 4 and 7 compared to day 0 (24.93 ± 3.41%,30.46 ± 5.24% vs 12.92 ± 4.20%,P < 0.01). These changes were accompanied by the significant improvement of villus height (500.54 ± 53.79 μm,459.03 ± 88.98 μm vs 210.94 ± 49.16 μm,P < 0.01),serum levels of total proteins (70.52 ± 5.13 g/L,74.89 ± 5.16 g/L vs 63.51 ± 2.47 g/L,P < 0.01),albumin (39.44 ± 1.18 g/L,42.39 ± 1.68 g/L vs 35.74 ± 1.75 g/L,P < 0.01) and f ibronectin (236.3 ± 16.5 mg/L,275.8 ± 16.9 mg/L vs 172.5 ± 21.4 mg/L,P < 0.01) at day 4 and 7,and prealbumin (286.38 ± 65.61 mg/L vs 180.88 ± 48.28 mg/L,P < 0.05),transferrin (2.61 ± 0.12 g/L vs 2.41 ± 0.14 g/L,P < 0.05) at day 7. Nitrogen excretion was signifi cantly decreased at day 7 (3.40 ± 1.65 g/d vs 7.25 ± 3.92 g/d,P < 0.05). No change was observed in the body weight. CONCLUSION:Recombinant human growth hormone could promote intestinal mucosal epithelial cell proliferation and protein synthesis in patients with enterocutaneous fi stula.