还原型谷胱甘肽对脓毒症患者急性肾损伤的治疗作用
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摘要
目的探讨还原型谷胱甘肽对脓毒症患者急性肾损伤(AKI)的治疗作用。方法选取我院2014年12月～2017年12月收治的80例脓毒症合并急性肾损伤患者作为研究对象,按照随机数字表法分成观察组(40例)和对照组(40例)。对照组给予常规综合治疗,观察组在常规综合治疗的基础上加用还原型谷胱甘肽治疗。比较两组的血肌酐(SCr)、尿素氮(BUN)、C反应蛋白(CRP)及急性生理学和慢性健康状况评分(APACHEⅡ评分)。结果两组治疗后3、7 d的CRP水平、APACHEⅡ评分,血SCr、BUN均较治疗前明显降低,且观察组治疗后3、7 d的上述指标均明显低于对照组,差异有统计学意义(P<0.05)。结论还原型谷胱甘肽能减轻脓毒症致急性肾损伤,从而改善患者的病情。
Objective To investigate the therapeutic effect of Reduced Glutathione on acute kidney injury(AKI) in septic patients. Methods From December 2014 to December 2017, a total of 80 patients with sepsis complicated with AKI were selected as objects. According to the random number table, all the patients were divided into the observation group(40 cases) and the control group(40 cases). The control group was treated with conventional comprehensive therapy, while the observation group was treated with Reduced Glutathione on the basis of routine comprehensive therapy.The levels of serum creatinine(SCr), blood urea nitrogen(BUN), C reactive protein(CRP) and acute physiology and chronic health status scores(APACH Ⅱ score) were compared between the two groups. Results The CRP level, APACHEⅡ score, blood SCr and BUN of the two groups were significantly lower than those of the control group at 3 and7 days after treatment, and the above indexes of the observation group were significantly lower than those of the control group at 3 and 7 days after treatment, and the differences were statistically significant(P<0.05). Conclusion Reduced Glutathione can alleviate AKI caused by sepsis and improve the patient′s condition.
Objective To investigate the therapeutic effect of Reduced Glutathione on acute kidney injury(AKI) in septic patients. Methods From December 2014 to December 2017, a total of 80 patients with sepsis complicated with AKI were selected as objects. According to the random number table, all the patients were divided into the observation group(40 cases) and the control group(40 cases). The control group was treated with conventional comprehensive therapy, while the observation group was treated with Reduced Glutathione on the basis of routine comprehensive therapy.The levels of serum creatinine(SCr), blood urea nitrogen(BUN), C reactive protein(CRP) and acute physiology and chronic health status scores(APACH Ⅱ score) were compared between the two groups. Results The CRP level, APACHEⅡ score, blood SCr and BUN of the two groups were significantly lower than those of the control group at 3 and7 days after treatment, and the above indexes of the observation group were significantly lower than those of the control group at 3 and 7 days after treatment, and the differences were statistically significant(P<0.05). Conclusion Reduced Glutathione can alleviate AKI caused by sepsis and improve the patient′s condition.
引文
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[16]侯静,蔺艳,欧三桃,等.还原型谷胱甘肽对缺血再灌注急性肾损伤模型大鼠的肾保护机制[J].中国老年学杂志,2016,36(22):5537-5539.
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[18]王艳丽,朱嘉理,王永剑,等.还原性谷胱甘肽治疗对乙酰氨基酚中毒的效果[J].实用医学杂志,2018,34(8):1347-1350.
[19]许诚楷,丁元林,孙明谨,等.还原型谷胱甘肽对早期慢性肾脏病患者氧化应激、血管新生及免疫功能指标的影响[J].中国老年学杂志,2017,37(19):4861-4863.
[20]张孝清,李素娟,曹国弟,等.还原型谷胱甘肽对氟中毒小鼠睾丸的影响[J].动物医学进展,2018,39(6):37-41.
[21]朱丹平,费曜.葛根素注射液联合还原型谷胱甘肽治疗糖尿病肾病的疗效观察[J].重庆医学,2017,46(25):3520-3522.
[2]Lee SY,Lee YS,Choi HM,et al.Distinct pathophysiologic mechanisms of septic acute kidney injury:role of immune suppression and renal tubular cell apoptosis in murine model of septic acute kidney injury[J].Crit Care Med,2O12,40(11):2997-3006.
[3]肖百芳,张亚娟,钟映玉,等.降钙素原对脓毒症致急性肾损伤患者预后评估的临床价值[J].医学临床研究,2016,33(3):510-512.
[4]Khwaja A.KDIGO Clinical Practice Guidelines for acute kidney injury[J].Nephrol Clin Pract,2012,120(4):179-184.
[5]徐建如,曹丝雨薇,江明.脓毒症并发急性肾损伤的早期生物标记物的研究进展[J].中国生化药物杂志,2017,37(3):27-29.
[6]王家阳,于洋,张帆,等.围术期应用他汀类药物对冠状动脉旁路移植术并发急性肾损伤疗效的研究进展[J].现代生物医学进展,2015,15(4):796-800.
[7]Alastair G,Proud F,Danny F,et al.Human models of acute lung injury[J].Dis Model Mech,2011,4(2):145-153.
[8]Perl M,Lomas-Neira J,Venet F,et al.Pathogenesis of indirect(secondary)acute lung injury[J].Expert REV Respir Med,2011,5(1):115-116.
[9]刘楠梅,王会玲,韩国锋,等.血红素氧化酶1过表达对急性损伤肾脏中骨髓间充质干细胞的影响[J].肾脏病与透析肾移植杂志,2015,24(5):441-446.
[10]高玉雷,柴艳芬,姚咏明,等.脓毒症免疫功能障碍机制及血必净调节效应研究进展[J].中华烧伤杂志,2013,29(2):162-165.
[11]Bagshaw SM,Uchino S,Bellomo R,et al.Septic acute kidney injury in critically ill patients:clinical characteristics and out comes[J].Clin J Am Soc Nephrol,2007,3(2):431-439.
[12]Zhuo W,Liao L,Fu Y,et al.Efficiency of endovenous versus arterial administration of mesenchymal stem cells for ischemia-reperfusion-induced renal dysfunction in rats[J].Transplant Proc,2013,45(2):503-510.
[13]yang CC,Hsu SP,Chen KH,et al.Effect of adenoviral catalase gene transfer on renal ischemia/reperfusion injury in rats[J].Chin J Physiol,2015,58(6):420-430.
[14]Scindia Y,Dey P,Thirunagari A,et al.Hepcidin mitigates renal ischemia-reperfusion injury by modulating systemic iron homeostasis[J].J Am Soc Nephrol,2015,26(11):2800-2814.
[15]Yan R,Li Y,Zhang L,et al.Augmenter of liver regeneration attenuates inflammation of renal ischemia/reperfusion injury through the NF-kappa B pathway in rats[J].Int Urol Nephrol,2015,47(5):861-868.
[16]侯静,蔺艳,欧三桃,等.还原型谷胱甘肽对缺血再灌注急性肾损伤模型大鼠的肾保护机制[J].中国老年学杂志,2016,36(22):5537-5539.
[17]明自强,俞林明,吕银祥,等.还原型谷胱甘肽对重度脓毒症患者多脏器功能的保护作用[J].实用医学杂志,2007,23(3):407-409.
[18]王艳丽,朱嘉理,王永剑,等.还原性谷胱甘肽治疗对乙酰氨基酚中毒的效果[J].实用医学杂志,2018,34(8):1347-1350.
[19]许诚楷,丁元林,孙明谨,等.还原型谷胱甘肽对早期慢性肾脏病患者氧化应激、血管新生及免疫功能指标的影响[J].中国老年学杂志,2017,37(19):4861-4863.
[20]张孝清,李素娟,曹国弟,等.还原型谷胱甘肽对氟中毒小鼠睾丸的影响[J].动物医学进展,2018,39(6):37-41.
[21]朱丹平,费曜.葛根素注射液联合还原型谷胱甘肽治疗糖尿病肾病的疗效观察[J].重庆医学,2017,46(25):3520-3522.