还原型谷胱甘肽治疗急性肾损伤临床效果的系统评价

Systematic Evaluation of Clinical Efficacy of Reduced Glutathione in the Treatment of Acute Kidney Injury

目的系统评价还原型谷胱甘肽治疗急性肾损伤(AKI)的有效性和安全性。方法通过检索Pubmed、EMbase、中国期刊全文数据库、中文期刊全文数据库、中国生物医学文献数据库及万方数据知识服务平台等数据库,收集还原型谷胱甘肽治疗AKI的随机对照试验(RCT),对符合条件的RCT进行Meta分析,采用RevMan 5.2软件进行统计学分析。结果共纳入17篇RCT研究,包含940例患者,对照组为常规护肾支持治疗方案,试验组在对照组基础上加用还原型谷胱甘肽。Meta分析结果显示,试验组在提高治疗有效率[OR=0.23,95%CI(0.14~0.38),P<0.00001]、缩短少尿期持续时间[OR=-2.11,95%CI(-2.95~-1.27),P<0.00001]、缩短血肌酐恢复正常时间[OR=-4.80,95%CI(-7.60~-2.01),P=0.0008]、缩短尿渗透压恢复正常时间[OR=-8.51,95%CI(-15.77~-1.25),P=0.02]、降低血肌酐[OR=-42.03,95%CI(-49.81~34.25),P<0.00001]、恢复内生肌酐清除率[OR=-11.64,95%CI(-19.15~-4.13),P=0.002]、降低尿N-乙酰-β-D-葡萄糖苷酶(NAG)[OR=-9.31,95%CI(-12.02~-6.60),P<0.00001]、降低胱抑素C[OR=-0.35,95%CI(-0.51~-0.18),P<0.0001]、降低尿氮素[OR=-3.55,95%CI(-5.38~-1.73),P=0.0001]方面显著优于对照组,差异有统计学意义。结论还原型谷胱甘肽能有效促进AKI患者肾功能的恢复,且具有较高的安全性。

Objective To systematically evaluate the effectiveness and safety of reduced glutathione in the treatment of acute kidney injury.Methods The dateset of Pubmed,EMbase,CNKI,Weipu Science and Technology Journal,China Biomedicine and Wanfang was searched.Randomized controlled trials on the clinical efficacy of reduced glutathione in the treatment of acute kidney injury were collected.meta-analysis of qualified RCTs will be performed,and RevMan 5.2 software was used for statistical analysis.Results A total of 17 randomized controlled trials and 940 patients were included.The control group was given routine kidney care support therapy,and the experimental group was added reduced glutathione on the basis of the control group.Meta-analysis results showed that the reduced glutathione experimental group improved the effective rate of patients with acute kidney injury[OR=0.23,95%CI(0.14~0.38),P<0.00001]and shortened the duration of oliguria[OR=-2.11,95%CI(-2.95~-1.27),P<0.00001],shorten the time for serum creatinine to return to normal[OR=-4.80,95%CI(-7.60~-2.01),P=0.0008],shorten urine osmotic pressure Time to return to normal[OR=-8.51,95%CI(-15.77~-1.25),P=0.02],reduce serum creatinine[OR=-42.03,95%CI(-49.81~34.25),P<0.00001],restore endogenous creatinine Clearance[OR=-11.64,95%CI(-19.15~-4.13),P=0.002],reduces NAG[OR=-9.31,95%CI(-12.02~-6.60),P<0.00001],reduces cyst Stastatin C[OR=-0.35,95%CI(-0.51~-0.18),P<0.0001],lower urea nitrogen[OR=-3.55,95%CI(-5.38~-1.73),P=0.0001].It is significantly better than the control group in other aspects,and the difference is statistically significant.Conclusion Reduced glutathione can effectively promote the recovery of renal function in patients with acute kidney injury,and has high safety.