The Study Of Changes Of Serum Immunoglobulin And Complement C3 In Patients With ARDS And The Effect Of CRRT On It

Purpose:Observation of acute respiratory distress syndrome patients serum IgG and IgA, IgM, IgG and complement C3 changes and continuous renal replacement therapy effect on the above indexes, to further explore the effects of CRRT on immune function in patients with acute respiratory distress syndrome (ARDS).Methods:24 cases of ARDS treated in the Affiliated Hospital of Yanbian University between January 2012 and December 2015 were selected.Among them, the A group of 12 cases as the control group, the day of diagnosis of ARDS is given mechanical ventilation, control of infection, control fluid intake, hormones, diuretics, protection of organ function, support for symptomatic treatment;B group of 12 cases is CRRT group, in the conventional treatment based on the combined application of CRRT.The levels of serum immunoglobulin IgA, IgM, IgG and complement C3 were measured in two groups:Before treatment, the treatment of third days, fifth days in the treatment of venous blood 2ml, separated serum, with BNProSpec automatic protein analyzer for determination.The acute physiology and chronic health status scores of the two groups were compared before and after treatment (physiology and chronic Acute Evaluation II health, APACHEII) score, mechanical ventilation time, ICU treatment time.Results:1. The two groups before treatment in patients with APACHE Ⅱ score no significant difference (P> 0.05), compared the before treatment and the treatment of the fifth day, two groups had different degrees of decreased (P< 0.05), group B decreased obviously, and two groups is statistically significant (P< 0.05); compared with, group B ICU retention time and the duration of mechanical ventilation were short, the two groups have statistical significance (P< 0.05).2.Changes of serum IgA, IgG, IgM and complement C3 concentration of Two groups of patients before and after treatment:before treatment (0h) of two groups of patients with serum IgA, IgG, IgM and complement C3 concentration comparison, no statistical difference (P> 0.05). Two groups in the serum of the patients with the index of concentration changes with time roughly the same, showed a downward trend (P< 0.05), compared with group A, the decline in group B patients serum IgA, IgG, IgM and complement C3 concentration in small amplitude, the two groups compared with statistical significance (P< 0.05).Conclusion:1. There are abnormal immune function in patients with acute respiratory distress syndrome (ARDS), the serum IgA, IgG, IgM, C3 have varying degrees of decreased CRRT by removal of inflammatory mediators, delay the decreasing degree of the index, so as to play a role in immune regulation.2. CRRT can reduce ARDS in patients with APACHEII score, shorten the time of mechanical ventilation and ICU stay, has obvious therapeutic implications for ARDS.