Yavuz L, Aynali G, Aynali A, Alaca A, Kutuk S, Ceylan B G
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
J Int Med Res. 2012;40(3):1166-74. doi: 10.1177/147323001204000337.
To determine the effect of immunoglobulin (Ig)M-enriched Ig therapy on mortality rate and renal function in sepsis-induced multiple organ dysfunction syndrome (MODS), using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.
Retrospective study of patients with sepsis-induced MODS treated with standard antibiotic plus supportive therapy (control group) or IgM-enriched Ig therapy adjuvant to control group therapy (IVIg group). Total length of stay in the intensive care unit (ICU), overall mortality rate and 28-day case fatality rate (CFR), as well as APACHE II scores and renal function parameters at day 1 and day 4 of therapy, were recorded.
A total of 118 patients were included (control group, n = 62; IVIg group, n = 56). In both groups, day 4 APACHE II scores decreased significantly compared with day 1 scores; the effect of treatment on renal function was minimal. Length of ICU stay, overall mortality rate and 28-day CFR were significantly lower in the IVIg group compared with the control group.
Adding IgM-enriched Ig therapy to standard therapy for MODS improved general clinical conditions and significantly reduced APACHE II scores, overall mortality rate and 28-day CFR, although effects on renal function were minimal.
采用急性生理与慢性健康状况评分系统II（APACHE II）评分，确定富含免疫球蛋白（Ig）M的Ig疗法对脓毒症诱发的多器官功能障碍综合征（MODS）患者死亡率及肾功能的影响。
对接受标准抗生素加支持治疗的脓毒症诱发MODS患者（对照组）或在对照组治疗基础上加用富含IgM的Ig疗法的患者（静脉注射免疫球蛋白组）进行回顾性研究。记录重症监护病房（ICU）的总住院时间、总死亡率和28天病死率（CFR），以及治疗第1天和第4天的APACHE II评分和肾功能参数。
共纳入118例患者（对照组62例；静脉注射免疫球蛋白组56例）。两组患者治疗第4天的APACHE II评分均较第1天显著降低；治疗对肾功能的影响极小。静脉注射免疫球蛋白组的ICU住院时间、总死亡率和28天CFR均显著低于对照组。
在MODS的标准治疗中加用富含IgM的Ig疗法可改善总体临床状况，并显著降低APACHE II评分、总死亡率和28天CFR，尽管对肾功能的影响极小。
