精氨酸对脓毒症患者CD14＋单核细胞HLA—DR表达的影响

Effect of arginine on the human leukocyte antigen - DR expression/CD14＋ monocytes in sepsis

目的探讨精氨酸对脓毒症患者白细胞分化抗原14（CD14＋）单核细胞人类白细胞抗原-DR（HLA—DR）表达及体液免疫的影响。方法将62例脓毒症患者随机分为治疗组（n=32）和对照组（n=30），两组患者在诊断为脓毒症的首日和治疗7d后次日晨抽取外周静脉血，检测外周血HLA—DR／CD14＋单核细胞表达百分率和免疫球蛋白，并记录患者生命体征及临床检验指标和28d病死率。治疗组在常规治疗的基础上加用精氨酸15g／d，连用7d。结果精氨酸治疗后，治疗组患者的外周血HLA—DR／CD14＋单核细胞表达百分率较治疗前及对照组治疗后均升高（P〈0．05）；血清IgG高于对照组（P〈0．01），IgA和IgM未见明显升高（P〉0．05）；两组患者间28d病死率差异无统计学意义（P〉0．05）。结论精氨酸能够提高脓毒症患者外周血HLA—DR／CD14＋单核细胞表达百分率，使IgG升高。

Objective To study the effect of arginine on the expressive rate of human leukocyte antigen- DR （HLA- DR）/CDI4 ~ monocytes and the humoral immunity in the patients with sepsis. Methods Sixty - two patients with sepsis were randomly divided into the treatment group （ n = 32） and control group （n = 30）. The expressive rate of human leukocyte antigen- DR （HLA- DR）/CD14＋ monocytes and immunoglobulin were measured on the first day of being diagnosed with sepsis and 7 - day after treatment, and the vital signs and clinical laboratory indicators and 28 d mortality were recorded. 15 g arginine was added once a day for 7 days in the treatment group. Results The expressive rate of HLA - DR/CD14＋ monocytes and IgG were higher in the treatment group than those in the control group after treatment （P 〈 0.05 and P 〈 0.01, respectively）. IgA and IgM were not significantly increased by the treatment （P 〉 0.05 ）, and 28 d mortality showed no significant difference between the two groups （P 〉 0.05）. Conclusion Arginine could increase the expression rate of HLA - DtL/CD14 ＋ monocytes and IgG in the patients with sepsis.