还原型谷胱甘肽对严重多发伤患者肝功能的保护作用

Protective effect of reduced glutathione on liver function in severe multiple trauma patients

目的探讨还原型谷胱甘肽(GSH)对严重多发伤患者肝功能保护作用的机制。方法将46例严重多发伤患者随机分为GSH组(n=23)和对照组(n=23)。GSH组使用GSH 1.8 g/d静脉点滴,对照组给予门冬氨酸钾镁40 mL/d静脉点滴,其他治疗两组相同,疗程均为7 d。于治疗前和治疗第8天测定血浆肿瘤坏死因子(TNF-α)和白细胞介素-6(IL-6)及血浆生化指标(AST、ALT、γ-GT)。结果GSH组与对照组在治疗前AST、ALT、γ-GT、TNF-α、IL-6比较差异无统计学意义。两组血浆AST、ALT、γ-GT治疗后均较治疗前降低(P<0.05),且GSH组较对照组下降明显(P<0.05)。治疗后GSH组TNF-α、IL-6下降较对照组明显(P<0.01)。结论GSH对严重多发伤时肝功能损伤有良好的保护功能,其作用机制与下调TNF-α和IL-6水平有关。

Objective To study the protective effect of reduced glutathione（GSH） on liver function in severe polytraurna patients. Methods 46 patients with severe multiple trauma were randomly divided into two groups. 23 patients were given GSH in a dose of 1.8 g/d through intravenous drip for 7 days as GSH group, and 23 patients were given potassium and magnesium aspartate 40 mL per day through intravenous drip for 7 days to serve as control group. The same treatment was given to both groups other than GSH. Plasma contents of tumor necrosis factor - α （ TNF - α ） and interleukin - 6 （ IL - 6 ） and biochemistrial indexes were measured on admission and eighth day in both groups. Results AST, ALT,γ- GT, TNF - α and IL - 6 were not different both in GSH group and routine treatment group before treatment. After the treatment, plasma AST, ALT and γ- GT were decreased in both groups, but the decrease of all the. indexes was more marked in GSH group （ P 〈0.05）. TNF- α and IL-6 levels reduced more significandy after treatment in GSH group than routine group （ P 〈0.01）. Condusion Reduced glutathione has beneficial effects in protecting liver function in patients with severe polytrauma,which may be related to the reduction of serum levels of TNF - α and IL - 6.