还原型谷胱甘肽治疗急性肾功能衰竭的随机对照试验

目的观察还原型谷胱甘肽对急性肾衰竭的疗效和安全性。方法采取抛硬币法将23例急性肾衰竭患者随机分为治疗组(n=10)和对照组(月=13)。治疗组在常规治疗的基础上给予还原型谷胱甘肽1200mg,静脉滴注,每日1次,疗程4周；而对照组只给予常规治疗。于治疗前及治疗第1、2、3、4周结束时检测血肌酐、尿素氮,疗程结束后评估近端、远端肾小管功能。观察记录主要临床症状的改善情况及药物不良反应。结果治疗组恶心、呕吐改善时间及少尿期持续时间明显短于对照组。治疗组血肌酐水平下降幅度虽大于对照组,但两组间比较差异无统计学意义。疗程结束时两组肾小管功能比较,治疗组优于对照组。结论还原型谷胱甘肽用于急性肾衰竭的治疗,有助于肾功能的早期恢复。但由于样本量较小,今后尚需开展更大样本,更高质量的随机对照试验加以验证。

A Randomized Controlled Trial of Reduced Glutathione in the Treatment of Acute Renal Failure

Objective To evaluate the effectiveness and safety of reduced glutathione in the treatment of acute renal failure.Methods Twenty-three patients with acute renal failure were divided into the treatment group (n=10) and the control group (n=13) by a simple random method.Patients in the treatment group received intravenous reduced glutathione 1 200 mg daily,whereas patients in the control group were not treated with reduced glutathione.The therapeutic course for the two groups was 4 weeks.Serum creatinine and urea nitrogen were determined before treatment as well as at the end of Week 1,2,3 and 4.Proximal and distal renal tubular functions were evaluated at the end of the treatment.The time when clinical symptoms were improved was recorded and adverse drug reactions were monitored.Results The durations of nausea and vomiting as well as the oliguria stage in the treatment group were obviously shorter than those of the control group. The serum creatinine level in the treatment group decreased more markedly than that of the control group.At the end of the treatment,the renal tubular function in the treatment group was better than that of the control group.Conclusion Reduced glutathione in the treatment of acute renal failure contributes to the early recovery of renal function.However,more high- quality and large-scale randomized controlled trials are needed.