[Influence of glutamine and growth hormone intensified nutrition support on immunomodulation in critically ill elderly patients].
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.
Cai
Guo-Long
GL
Intensive Care Unit, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China. caiguolong725@hotmail.com
Yan
Jing
J
Yu
Yi-hua
YH
Zhang
Zhao-cai
ZC
Gong
Shi-jin
SJ
Dai
Hai-wen
HW
Chen
Jin
J
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
D005973:Glutamine; D019382:Human Growth Hormone