重组人生长激素和谷氨酰胺的强化营养对老年脓毒症患者应激和免疫状态的临床疗效

Clinical therapeutic effect of enriched nutrition with growth hormone and glutamine on stress status and immune function in elderly patients with sepsis

目的:观察重组人生长激素和谷氨酰胺的强化营养对老年脓毒症患者应激及免疫状态的临床疗效。方法:40例老年脓毒症患者,随机分为实验组和常规组,每组20例。常规组给予标准营养支持治疗,实验组加用生长激素和谷氨酰胺,疗程为14 d,观察2组患者在实验前1 d及实验后第7、14天的应激状态(C3、C4、CRP)和免疫功能(CD4+、CD8+、CD4+/CD8+、IgG、IgM)的变化。结果:实验前2组患者血C3、C4及CRP无明显差异,室验后第7、14 d实验组较常规组有明显改善(P<0.05)。老年脓毒症患者入院时均有明显的免疫抑制,实验组(CD4+、CD8+、CD4+/CD8+、IgG、IgM)在第7、14 d与常规组相比有改善(P<0.05)。结论:重组人生长激素和谷氨酰胺强化营养2周能有效地改善老年脓毒症患者的应激和免疫状态。

Objective：To observe the effect of growth hormone （rhGH） and glutamine （Glu） enriched nutrition on stress status and immune function in elderly patients with sepsis.Methods：Forty elderly patients with sepsis were randomly divided into experimental group and routine group （20 cases each）.Patients in routine group were given standard nutritional support,while experimental group were given standard nutritional support ＋ GIu 100 mL/d ＋ rhGH 10 U/d.Tests for the stress status （levels of C3,C4 and CRP） and immune function （changes of CD4 ＋,CD8 ＋cells and CD4 ＋/CD8 ＋,IgG,IgM） were observed one day before experiment and at 7 and 14 days after experiment.Results：Levels of C3,C4 and CRP showed no significant differences in two groups before experiment,but they were improved after experiment at 7 and 14 days than that in routine group （P ＜ 0.05）.Experimental group had improved immune function compared with that of routine group at the 7 and 14 days after experiment （P ＜ 0.05）.Conclusion：Growth hormone and Glu enriched nutrition can effectively ameliorate the stress status and enhance immune function in critically ill elderly patients.