N-乙酰半胱氨酸治疗对血液透析患者炎症因子和营养状态的影响  

Effect of N-acetylcysteine on inflammation factors and nutritional status in hemodialysis patients

作　　者：王艺萍[1] 赵娜[1] 杨乃宁[1] 于春洋[1] 柴丽萍 

机构地区：[1]航天中心医院肾内科,北京100049 [2]海军招收飞行学员工作办公室体检科,北京100071

出　　处：《兰州大学学报（医学版）》2016年第6期48-52,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：中国航天科工集团公司医疗卫生科研项目(2014JKBZ001)

摘　　要：目的评估N-乙酰半胱氨酸(NAC)治疗是否可改善维持性血液透析(MHD)患者的炎症指标和营养状态。方方法选择持续血液透析6个月以上的患者71例,随机分为NAC治疗组(NAC 600 mg,2次/d)41例和对照组(不服用任何药物)30例。收集常规临床资料,开始为期3个月的观察,分别于治疗前后检测患者的炎症因子高敏C反应蛋白、白细胞介素-6、白细胞介素-10、肿瘤坏死因子、同型半胱氨酸水平,评估治疗前后血红蛋白、血清白蛋白、前白蛋白等营养指标。结果血液透析患者NAC治疗3个月后,高敏C反应蛋白、白细胞介素-6较治疗前显著降低(均P<0.01);同型半胱氨酸较治疗前显著降低(P<0.05);血红蛋白、血清白蛋白、前白蛋白水平明显升高(分别为P<0.05和P<0.01);女性MHD患者治疗前后高敏C反应蛋白的降低值显著高于男性患者(P<0.01)。结论 NAC治疗可降低血液透析患者炎症因子水平,改善营养状态,从而使血液透析患者从抗炎治疗中获益。Objective To evaluate the effect of oral N-acetyl-cysteine （NAC） on the serum levels of inflamma- tory factors and nutritional status in maintenance hemodialysis patients （MHD）. Methods Seventy-one MHD patients who had undergone hemodialysis for at least six months were recruited in the study. The patients were randomly divided into the treatment group （19 males and 22 females） who received NAC （600 mg, twice a day） for three months and the control group （15 males and 15 females） without taking any medicine. Nutrition- al status, Serum hs-CRP, IL-6, IL-10, TNF-α, Hcy, Hgb, Alb, and PA, etc were measured at the experiment onset and 3 months later. Results After 3 months intervention, a significant decreased serum levels of hs-CRP （P 〈 0.01）, IL-6 （P 〈 0.01） and Hcy （P 〈 0.05） were found in treatment group when compared with the control group. A significant increased serum levels ofHgb （P 〈 0.05）, Alb （P 〈 0.05） and PA （P 〈 0.01） were observedfollowing NAC treatment. The female patients represented with a significantly decreased serum levels of CRP compared with the males, P 〈 0.01. Conclusion The short-term oral NAC treatment might result in the reduction of inflammatory factors and improvement of nutritional status in MHD patients, patients may get benefit from the anti-inflammatory effects of NAC.

关 键 词：血液透析 N-乙酰半胱氨酸 炎症因子 营养 

分 类 号：R692.5[医药卫生—泌尿科学]