谷胱甘肽联合前列地尔治疗脓毒症急性肾损伤的效果

Effect of Glutathione combined with Alprostadil treating acute kidney injury in sepsis

目的探讨谷胱甘肽联合前列地尔治疗脓毒症急性肾损伤的效果。方法回顾性分析2017年1月~2019年6月广州市白云区第二人民医院重症医学科收治的80例脓毒症急性肾损伤患者临床资料,按不同药物治疗方式分为联合组和对照组,每组各40例。对照组予以常规静脉滴注前列地尔,10μg/次,qd;联合组在对照组治疗的基础上加以谷胱甘肽治疗,0.6 g/次,qd,两组均予以治疗10 d。观察两组治疗10 d后的疗效及血清中组织纤溶酶原激活物(TPA)、纤溶酶原激活物抑制物(PAI-1)水平的变化;采用急性生理与慢性健康评分(APACHEⅡ)、全身感染相关性器官功能衰竭评分(SOFA)评估病情变化。结果联合组治疗总有效率高于对照组,差异有统计学意义(P<0.05);联合组血清TPA、PAI-1平低于对照组,差异有统计学意义(P<0.05);联合组APACHEⅡ、SOFA评分低于对照组,差异有统计学意义(P<0.05)。结论谷胱甘肽联合前列地尔在脓毒症急性肾损伤治疗中可提高疗效,降低体内TPA、PAI-1水平。

Objective To explore the effect of Glutathione combined with Alprostadil treating acute kidney injury in sepsis.Methods The clinical data of 80 patients with acute kidney injury in sepsis admitted to the Department of Intensive Medicine of the Second People′s Hospital of Baiyun District,Guangzhou from January 2017 to June 2019 were analyzed retrospectively.According to the different drug treatment methods,they were divided into the combined group and the control group,40 cases in each group.The control group received routine intravenous drip of Alprostadil,10μg/time,qd;the combined group received glutathione treatment on the basis of the control group,0.6 g/time,qd,both groups were treated for 10 days.The curative effect at 10 days after treatment and the changes in serum tissue plasminogen activator(TPA)and plasminogen activator inhibitor(PAI-1)levels of the two groups were observed;the acute physiology and chronic health scores(APACHEⅡ),systemic infection-related organ failure score(SOFA)were used to assess the changes in patients′condition.Results The total effective rate of the combined group was higher than that of the control group,the difference was statistically significant difference(P<0.05);the serum TPA and PAI-1 levels of the combined group were lower than those of the control group,there were statistically significant differences(P<0.05);the APACHEⅡand SOFA scores of the combined group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion Glutathione combined with Alprostadil can improve the therapeutic effect and reduce the levels of TPA and PAI-1 in patients with acute kidney injury in sepsis.