严重烧伤过程中大剂量补充精氨酸体内相关指标变化及对脓毒症发生的影响

目的观察大剂量补充精氨酸(arginine,Arg)对严重烧伤患者白细胞介素-16(IL-16)、白细胞介素-17(IL-17)、血清C反应蛋白(C-reactive protein,CRP)及脓毒症发生的影响。方法将2008年1月~2014年3月收治的重度以上烧伤住院患者201例,按随机数字表法分为试验组(n=112)和对照组(n=89),对照组精氨酸剂量0.1g/kg,试验组剂量0.4g/kg,观察两组患者治疗前及治疗后3、7、14d血清IL-16、IL-17、CRP变化,并统计两组脓毒症发病率。结果治疗7d后,试验组患者IL-16、IL-17、CRP较对照组显著下降(P﹤0.01);脓毒症发病率显著低于对照组(P﹤0.05)。结论大剂量Arg的补充能够降低严重烧伤患者体内炎症反应;降低脓毒症的发病率,可能是通过降低患者IL-16、IL-17、血清CRP的水平来实现的。

Effect of large doses of arginine supplementation on changes of relative parameters and on the occurrence of sepsis in severe burn

Objective To observe the effect of large doses of arginine ( Arg) supplementation on interleu-kin-16(IL-16),interleukin-17(IL-17),serum C reactive protein(CRP) and the occurrence of sepsis in severely burned patients . Methods Totally 201 patients with severe burn were randomly divided into the experimental group(n=112) and the control group (n=89).The control group received Arg with a dose of 0.1g/kg,and the experimental group received Arg with a dose of 0.4g/kg.The changes of serum IL-16,IL-17,and CRP were ob-served in both groups before treatment and at 3,7,14d after treatment.Also,the incidence of sepsis were statistical-ly analyzed.Results At 7d after treatment,the levels of IL-16,IL-17,and CRP in the experimental group were sig-nificantly lower than those in the control group ( P<0.01);and the incidence of sepsis in the experimental group was significantly lower than that in the control group (P<0.05).Conclusion High dose of Arg supplementation can reduce the inflammatory response in severe burn patients and reduce the incidence of sepsis ,which may be achieved by reducing the levels of serum CRP ,IL-17,and IL-16.