title: [Influence of glutamine and growth hormone intensified nutrition support on immunomodulation in critically ill elderly patients].
abstract: OBJECTIVE
  To evaluate the impacts of glutamine (Gln) and recombinant human growth hormone (rhGH) intensified nutrition support on critically ill elderly patients.
  
  
  METHODS
  Ninety critically ill aged patients were included in a prospective, randomized and controlled clinical study, and randomly divided into three groups: group A (standard nutrition support), group B (standard nutrition support+10% Gln 100 ml/d), group C (standard nutrition support+ Gln 100 ml/d+rhGH 10 U/d). Before treatment and then 7 and 14 days after treatment, blood samples were collected for analysis of serum proteins including albumin (ALB), pre-albumin (PAB), C-reactive protein (CRP), immunoglobulin G (IgG). Meanwhile, the variables including T-cell subsets, CD14 human leukocyte antigen (locus) DR (CD14 HLA-DR), and total lymphocytes were measured. The changes in acute physiology and chronic health evaluation II (APACHE II) and multiple organ dysfunction syndrome (MODS) scores, the durations of intensive care unit (ICU) stay and mechanical ventilation, and 28-day survival rate were recorded.
  
  
  RESULTS
  Comparing with group A and B, the levels of serum ALB, PAB and IgG were significantly elevated in group C. The T-cell subsets, CD14 HLA-DR and the number of total lymphocytes were markedly higher in group C (P<0.01), and the APACHE II and MODS scores were decreased significantly in group C (P<0.05 or P<0.01). The levels of serum CRP were lowered significantly in group C (P<0.01). There were no significant differences in the durations of ICU stay, mechanical ventilation and 28-day survival rate among three groups (all P>0.05).
  
  
  CONCLUSIONS
  Gln and rhGH intensified nutrition support can improve nutritional condition and immune function, downregulate the inflammatory response in the critically ill elderly patients.
authors.affiliation: Intensive Care Unit, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China. caiguolong725@hotmail.com
authors.forename: Guo-Long
authors.initials: GL
authors.lastname: Cai
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
authors.forename: Yi-hua
authors.initials: YH
authors.lastname: Yu
authors.forename: Zhao-cai
authors.initials: ZC
authors.lastname: Zhang
authors.forename: Shi-jin
authors.initials: SJ
authors.lastname: Gong
authors.forename: Hai-wen
authors.initials: HW
authors.lastname: Dai
authors.forename: Jin
authors.initials: J
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D056747:Immunomodulation; D008297:Male; D018529:Nutritional Support; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D005973:Glutamine; D019382:Human Growth Hormone