还原型谷胱甘肽对体外冲击波碎石术肾功能损害的防护

Protection of renal function from damage due to ESWL by reduced glutathione

目的研究还原型谷胱甘肽(阿拓莫兰)体外冲击波碎石术(ESWL)对肾功能的损害的保护作用。方法接受ESWL治疗的肾结石患者32例,随机分为阿拓莫兰组和对照组,每组16例。阿拓莫兰组在ESWL开始时及ESWL后1、23、、4天静滴阿拓莫兰1.2g加0.9%生理盐水250ml,对照组静滴0.9%生理盐水250ml。两组于ESWL前1天及后1、4、7天取血、尿标本,观察ESWL后血清超氧化物歧化酶(SOD)、丙二醛(MDA)及尿N-乙酰--βD氨基葡萄糖苷酶/肌酐(NAG/Cr)的变化。结果两组在ESWL后血清SOD活力均降低,血清MDA和尿NAG/Cr则均升高,而阿拓莫兰组SOD活力降低幅度和MDA、NAG/Cr升高幅度都远不及对照组明显。结论ESWL对肾脏的损害与肾组织氧自由基增多有关,还原型谷胱甘肽(阿拓莫兰)可减少肾组织氧自由基的产生,保护肾脏,缓解ESWL引起的肾损伤。

Objective To study the protection of renal function from damage due to ESWL by reduced glutathione. Methods Thirty-two patients were randomly divided into two groups before ESWL, the reduced glutathione group and the control group. Each group consisted of sixteen patients. The reduced glutathione injection was given to the former during ESWL and 1,2,3,4 days after ESWL, while only normal Saline to the latter. We took blood and urine samples on the first day before and 1,4,7 days after ESWL to determine the levels of blood SOD, MDA and the level of NAG in the urine. Results The levels of blood SOD were decreased while the levels of blood MDA and urinary NAG were increased in both groups after ESWL. The changes of SOD, MDA, NAG/Cr in the reduced glutathione group was not so obvious as those in the control group. Conclusion Renal injury during ESWL is due to the increased oxygen free radical, and reduced glutathione can eliminate the oxygen free radical to protect the kidney from the damage due to ESWL.