还原型谷胱甘肽联合CRRT治疗脓毒症相关急性肾损伤患者疗效及对血清MDA、hs-CRP水平的影响  

Curative effect of reduced glutathione combined with CRRT and its influences on levels of serum MDA and hs-CRP in patients with sepsis associated acute kidney injury

作　　者：秦志丹[1] 蒙永毅[1] 吴英林[1] 胡杰妤[1] 陈强[1] Oin Zhidan;Meng Yongyi;WU Yinglin;Hu Jieyu;Chen Qiang(Department of Critical Care Medicine,First Affiliated Hospital of Guangxi Medical University,Nanning,China.)

机构地区：[1]广西医科大学第一附属医院重症医学科

出　　处：《实用休克杂志（中英文）》2023年第5期269-272,281,共5页Journal of Practical Shock

基　　金：2020年广西壮族自治区卫生健康委员会自筹经费科研基金课题(项目编号:Z20201429)。

摘　　要：目的探讨还原型谷胱甘肽(GSH)联合连续性肾替代治疗(CRRT)治疗脓毒症相关急性肾损伤(AKI)患者疗效及对血清丙二醛(MDA)、超敏C反应蛋白(hs-CRP)水平的影响。方法选取2020年1月~2022年12月广西医科大学第一附属医院重症医学科收治的100例SA-AKI患者,按照治疗方法不同分为A组和B组各50例。B组采用CRRT治疗,A组在B组基础上采用GSH进行联合治疗,均持续治疗7d。比较两组临床疗效和治疗前后血清Scr、BUN、中性粒细胞明胶酶相关脂质运载蛋白(sNGAL)、丙二醛(MDA)、总抗氧化能力(TAOC)、SOD、hs-CRP、PCT和TNF-α水平及治疗期间不良事件发生率。结果A组SA-AKI患者治疗总有效率为74.00%,显著高于B组的40.00%(P<0.05);治疗后,A组Scr、BUN和sNGAL水平均明显低于B组(P<0.05);A组MDA水平显著低于B组,TAOC和SOD水平均显著高于B组(P<0.05);A组hs-CRP、PCT和TNF-α水平明显低于B组(P<0.05);A组治疗期间不良事件发生率为18.00%,与B组的8.00%无显著差异(P>0.05)。结论GSH联合CRRT治疗可提高AS-AKI临床疗效,降低血清MDA、hs-CRP水平。Objective To explore the curative effect of reduced glutathione(GSH)combined with continuous renal replacement therapy(CRRT)and its influences on levels of serum malondialdehyde(MDA)and hypersensitive C-reactive protein(hs-CRP)in patients with sepsis-associated acute kidney injury(AKI).Methods A total of 100 patients with SA-AKI admitted to Critical Care Medicine Department of the First Affiliated Hospital of Guangxi Medical University were enrolled between January 2020 and December 2022.According to different treatment methods,they were divided into group A(GSH combined with CRRT)and group B(CRRT),50 cases in each group.All were treated for 7d.The clinical curative effect,levels of serum Scr,BUN,neutrophil gelatinase-associated lipocalin(sNGAL),malondialdehyde(MDA),total antioxidant capacity(TAOC),superoxide dismutase(SOD),hs-CRP,procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)before and after treatment,and the incidence of adverse events during treatment were compared between the two groups.Results The total response rate of treatment in group A was significantly higher than that in group B(74.00%us.40.00%,P<0.05).After treatment,levels of Scr,BUN and sNGAL in group A were significantly lower than those in group B(P<0.05).MDA level in group A was significantly lower than that in group B,while levels of TAOC and SOD were significantly higher than those in group B(P<0.05).The levels of hs-CRP,PCT and TNF-αin group A were significantly lower than those in group B(P<0.05).There was no significant difference in the incidence of adverse events between group A and group B during treatment(18.00%us.8.00%,P>0.05).Conclusions GSH combined with CRRT can improve clinical curative effect on AS-AKI,reduce levels of serum MDA and hs-CRP.

关 键 词：还原型谷胱甘肽 连续性肾替代治疗 脓毒症 急性肾损伤 丙二醛 超敏C反应蛋白 

分 类 号：R459.7[医药卫生—急诊医学] R692[医药卫生—治疗学]