免疫調節配方對加護病房患者淋巴球分佈及白血球黏著分子表現之影響

This study compared the effects of immune-modulating and general balanced formulas on lymphocyte distribution and leukocyte adhesion molecule expression in intensive care unit (ICU) patients. Twelve patients with Acute Physiology and Chronic Health Evaluation (APACHE) II score 8~15 were allocated to 2 groups. Control group received general balanced formula whereas test group received either one of the immune-modulating formula (Impact-glutamine or Nu-Immune). The immune-modulating formulas contain arginine ω-3 fatty acid and glutamine in addition to complete balanced nutrition. Blood samples were collected before and 3 and 7 d after enteral feeding in all patients, and were analyzed for lymphocyte distribution and leukocyte adhesion molecule expression by flow cytometry. The results showed that after enteral feeding for 3 days, the CD8 percentage was higher and CD4/CD8 ratio was lower in the test group than those of the control group. There were no differences in CD3, CD4, CD8, CD19 distribution and leukocyte CD11a/CD18, CD11b/CD18 expression before and after enteral feeding in both groups. Also, no differences in these parameters were observed between the 2 groups. Since CD3 is the marker of T cells and CD19 is the marker of B cells, and CD11a/CD18, CD11b/CD18 expression are correlated with inflammatory reaction, these results suggest that immuno-modulating formulas do not result in immunosuppression. Compared with the balanced formula, immuno-modulating formula had no favorable effect on lymphocyte distribution and leukocyte associated inflammation in ICU patients.