摘要
目的探讨还原型谷胱甘肽联合高通量血液透析治疗对急性肾损伤(AKI)患者血清胱抑素C(Cys-C)、肾损伤分子-1(KIM-1)及肌酐(SCr)的影响。方法将76例AKI患者随机分为对照组和观察组各38例,均给予综合性治疗,对照组给予高通量血液透析治疗,观察组基于以上治疗基础再给予还原型谷胱甘肽治疗,对比两组临床疗效、少尿期、多尿期及血肌酐恢复期时间和治疗前及治疗7d后的血清肾损伤生物标志物,评估两组治疗安全性。结果观察组的临床总有效率显著高于对照组(84.21%vs 63.16%,P<0.05);观察组的少尿期、多尿期及血肌酐恢复期时间显著短于对照组(P<0.05);治疗7d后,两组血清Cys-C、KIM-1、SCr及ALR均显著下降,观察组变化幅度显著大于对照组;观察组和对照组的不良反应总发生率和30d死亡率对比,差异无统计学意义(13.16%vs 7.89%和2.63%vs 7.89%,P>0.05)。结论还原型谷胱甘肽联合高通量血液透析治疗AKI疗效确切,可明显改善患者肾功能,缩短其少尿期、多尿期及血肌酐恢复期时间,临床应用安全性良好。
Objective To explore the effects of reduced glutathione combined with high-flux hemodialysis on serum cystatin C(Cys-C),kidney injury molecule-1(KIM-1)and creatinine(SCr)in patients with acute kidney injury(AKI).Methods 76 patients were randomly divided into control group(38 cases)and observation group(38 cases).All patients were given comprehensive treatment.The control group was given high-flux hemodialysis.The observation group was given reduced glutathione based on the above treatment.The clinical efficacy,oliguria duration,polyuria duration and serum creatinine recovery time,and serum kidney injury biomarkers before treatment and after 7d of treatment were compared between the two groups.The treatment safety was evaluated in the two groups.Results The total clinical effective rate in observation group was significantly higher than that in control group(84.21%vs 63.16%,P<0.05).The oliguria duration,polyuria duration and serum creatinine recovery time in observation group were significantly shorter than those in control group(P<0.05).After 7d of treatment,the levels of serum Cys-C,KIM-1,SCr and ALR were significantly decreased in the two groups,and the changes in observation group were significantly greater than those in control group.There were no statistically significant differences in the total incidence rate of adverse reactions and 30d mortality rate between observation group and control group(13.16%vs 7.89%,2.63%vs 7.89%,P>0.05).Conclusion Reduced glutathione combined with high-flux hemodialysis has exact efficacy in the treatment of AKI,and it can significantly improve the renal function,shorten the oliguria duration,polyuria duration and serum creatinine recovery time,and it has good safety in clinical application.
作者
杨帆
童婧涵
李会
陈洁
代丽明
YANG Fan;TONG Jinghan;LI Hui;CHEN Jie;DAI Liming(Department of Nephrology, The First People's Hospital of Guangyuan, Guangyuan 628017, Sichuan, China)
出处
《西部医学》
2020年第6期863-867,共5页
Medical Journal of West China
基金
四川省科技厅科研课题(2014JY007105)。