免疫调理联合谷氨酰胺治疗多器官功能障碍综合征的临床研究

The clinical research of multiple organ dysfunction syndrome by the therapy of glutamine and immunomodulation

目的通过实施免疫刺激治疗和抗炎治疗,同时联合应用谷氨酰胺治疗,观察其对多器官功能障碍综合征的治疗效果。方法采用前瞻、随机、对照的研究方法,将患者分为常规治疗组(A组)和谷氨酰胺联合免疫调理治疗组(B组),观察单核细胞CD14HLA-DR、IL-6、IL-10、CD4/CD8和C-反应蛋白的变化,并统计两组治疗的病死率。结果A组和B组患者血浆单核细胞CD14HLA-DR、CD4/CD8、IL-6、IL-10和C-反应蛋白的水平明显高于C组(P<0.05)。B组与A组相比,CD14HLA-DR、CD4/CD8的表达水平均明显提高(P<0.05);IL-6、IL-10水平、CRP和病死率明显下降(P<0.05)。结论联合免疫调理治疗及谷氨酰胺治疗能改善MODS患者的免疫麻痹状态,下调炎症反应,提高MODS患者的治愈率。

Objective Through the implementation of the immune stimulation and anti-inflammatory treatment, at the same time the joint application of glutamine treatment, the effect of the multiple organ dysfunction syndrome was observed. Methods Prospective, randomized, controlled research methods were used, and patients were divided into conventional treatment group （A group） and glutamine combined immunomodulation group （B group）. CD14HLA-DR, CIM/CD8,IL-6, IL - 10 and C-reactive protein were detected ,so it＇ s with the mortality statistics of the two groups. Results CD14HLA-DR, CIM/CD8, IL-6, IL-10 and C-reactive protein of A group and B group were significantly higher than C group （ P 〈 0. 05 ）. Compared with A group, the expression of CD14HLA-DR and CD4/CD8 of B group was significantly increased （ P 〈 0. 05 ） ; IL-6, IL-10 , CRP and mortality of B group were decreased significantly （P 〈 0. 05 ）. Conclusion Combined immunomodulation and glutamine therapy,it can improve the immune paralysis, reduced inflammatory response and improve mortality of the patients with MODS.