The Influence Of Albumin And Fresh Frozen Plasma To Natural Immunity

IntroductionFluid resuscitation was important treatment for critical patient in ICU. The discussion of whether crystalloid or colloidal solution to be used and which colloidal solution had last for several ten years. The SAFE study in 2004 confirmed the similar treatment effect of patient received 4% albumin or saline for fluid resuscitation in the intensive care unit. Although this study had been get the high evaluation from Dr. Deb.orah Cook of McMaster University in Canadian who thinked that the study SAFE was not only the new classial trail for clinic tes, but also can be the important milestone in the development o critical medical care. But the choice of which fuuid to be used in ICU had made the difference conclusion in the research therewith.The fresh frozen plasma and albumin was used very popular in ICU. The research showed the abuse of fresh frozen plasma and albumin was very often in clinic which made us want to know what influence was made by these two fluids. At present , a large,randomized controlled trial are difficult to put into effect with the patient. Therefore, we can think about to find another way to cmpare the the characteristics of different fluid using in resuscitationMODS was one of the main death reasons in ICU recently. MODS was easily to develop to MOF which's death rate was about 50-90%. There was various theories had been put forward by scholars both abroad and at home in which immunologic dissonance theory occupied important position after the fasting development of modern immunologic technology. The research showed that inhibiting general immunity and improving natual immunity can reach the balance of immunity.With the fact that the new experiment systme that the viewpoint builds judging by system in terms of studies the system- - - - - - entire whole blood natural experiment studies system is already very perfect, it passes the method coming to study natural immunoreaction's the natural state simulating the body inner , is considered designing reasonableness , the objective, similar body inner natural state. Therefore, can with the important index that the natural immune reaction body fluid function changes, complement C3 , C4 and important erythrocyte surface sign CD55 are the index studying, use natural experiment of whole blood.Objectives(1)To study the C3, C4 changed after receiving albumin or foreign body blood plasma in natural system.(2)To study CD55 on the surface of red blood changed after receiving albumin or foreign blood plasma.Materials and methodsPartⅠFour ml blood was taken from 25 male adult donors respectively. And 400ul citric acid were added to the samples as the anticoagulation agent before centrifugation at 2500 rpm/min for 5 min under room temperature. Upper serum was taken and diluted with equal volume of saline. Each sample were divided into four groups: the Allogeneic Plasma Group was added with 0.4 ml whole blood, 0.6 ml autologous plasma, and 0.4 ml allgeneic plasma; the Albumin Group was added with 0.4 ml whole blood, 0.6 ml autologous plasma, and 0.4 ml albumin; the Negative Control was added with 0.4 ml whole blood, 0.6 ml autologous plasma, and 0.4 ml saline; and the Positive Control were added with 0.4 ml allgeneic plasma, 0.6 ml autologous plasma, and 0.4 ml E. coli suspension in PBS buffer. All the samples were gently swayed under 37℃water bath for1 hour, then subjected for centrifugation under room temperature at 2000 rpm/min for 5min. Upper serum wsd taken for C3 and C4 test, and analyzed by the SPSS software, x±s each group of C3, C4 difference with Mann-Whitney-u-test. p<0.05 is the difference has the remarkable significance.PartⅡThe trial object choice was same as the first part, after takes in the above process the centrifugal lower level cell to measure CD55 express on red blood cell .Unifies mutually with the RBC molecular marker (CD55) immune body, carries on flow cytometry examination, judges in the CD55 expredd on red blood cell according to the changes of fluorescence intensity of molecular marker , carries on the data analysis take the SPSS software, the data by X±S and the activation rate expression, the activation rate as (experimental group or positive contrasting group --negative contrasting group)/the negative contrasting group, examines during each group with Student-newman-keuls X±S and the activation rate difference, p<0.05 is the difference has the remarkable significance.ResultsPartⅠThe C3 figure in foreign body plasma was (0.1089+0.1640), Albumin group (0.1186+0.16149), saline group (0.1182+0.16149), bacterial group (0.0856+0.1378) .The C3 figure in group receiving foreign body plasma was significant higher than negative contrasting group, positive contrasting group and the group receiving albumin, (P<0.05). The C3 figure in group receiving albumin was significant higher than positive contrasting group. (P< 0.05), and higher than negative contrasting group but without statistical significance. (P > 0.05) .C4 figure in foreign body plasma(0.6983+0.1640), Albumin group(0.5486+0.15072) ,group(0.5486+0.15072,the saline group(0.5335+0.15066), bacterail group (0.4317+0.14126). The C4 figure between each two groups of foreign body plasma, plasma, saline, bacterial was no difference.PartⅡThe CD 55 express in foreign body plasma was(13.7792+1.95611), albumin group(13.7032+1.53900),saline group(12.1056+1.26006),baterial group(16.0932+2.19021). The CD 55 express on the surface of RBC in group receiving foreign blood plasma and albumin were significant higher than negative contrasting group and significant lower than positive contrasting group(P<0.05). The CD55 express in group receiving foreign blood plasma was higher than group received albumin, but without statistical significance. (P<0.05). The activation rates of groups received foreign body plasma and albumin were both significant lower than group received bacteria.(P< 0.05). The activation rates between groups received foreign body plasma and albumin had no statistical significance.(P.> 0.05)Conclusions(1)Receiving fresh frozen plasma can signifiance increase the complement in body than receiving albumin. It may because of the complement in foreign body plasma or the plasma activing the the natural immunity system.(2)The complenment decreased in group baterial proved again that there was inherent immune reaction to pathegon which can be recongized by complement system in blood circulaton. .(3)The CD55 express in group albumin and bacterial were both increased than group saline. While the C3 level comparement were difference. This result indicates that there was multiple ways influence the level of C3, the CD55 had little effect to C3.(4) Compare to saline, the fresh frozen plasma and albumin can both regulated the immune function of patients. Giving plasma can up-regulated the content of complement which can improve the immune function of body when the patient was in low level of complement. It should avoid using plasma when the patient had high level of complement especially in state of SIRS. It was better to use albumin or saline to avoid aggravating inflammation.