【摘要】 目的探讨还原型谷胱甘肽和黄芪对体外冲击波碎石(ESWL)致肾损伤的保护作用和可能机制。方法将60例单侧肾结石患者随机分成4组:还原型谷胱甘肽(GSH)组、黄芪组、GSH+黄芪组和对照组,于ESWL治疗开始时及术后1 d、2 d、3 d、4 d各组分别静点GSH、黄芪、GSH+黄芪和生理盐水,测定ESWL前后不同时间点血清SOD、MDA、GSH-Px及尿NAG/肌酐变化。结果ESWL治疗后GSH组和黄芪组SOD降低及MDA升高幅度低于对照组(P<0.05),且两组之间无显著差异(P>0.05);GSH+黄芪组ESWL前后SOD与MDA变化无统计学意义(P>0.05),且变化幅度低于其他三组(P<0.05);黄芪组与GSH+黄芪组GSH-Px无显著差异(P>0.05),但术后明显高于术前(P<0.05),其他两组ESWL前后GSH-Px无明显变化(P>0.05);GSH+黄芪组尿NAG/肌酐升高幅度低于其他三组(P<0.05),术后4 d恢复正常,其他三组术后7 d恢复正常。结论还原型谷胱甘肽和黄芪对ESWL致肾损伤有相同的保护作用,但联合用药效果优于单独用药。更多还原

【Abstract】 Objective To study the protective effects and probable mechanisms of reduced glutathione and Astragalus membranaceus(Huangqi) on renal injuries induced by ESWL.Methods Sixty patients of renal calculus were randomly divided into 4 groups: reduced glutathione(GSH),Astragalus membranaceus,reduced glutathione and Astragalus membranaceus,matched control.Every group was given GSH,Astragalus membranaceus,reduced glutathione and Astragalus membranaceus,saline for initiation of ESWL and 1,2,3,4 days after ESWL respectively.SOD,MDA,GSH-Px and NAG/ creatinine in blood serum and urine samples at different time points were detected.Results After ESWL,the decrease of SOD and increase of MDA in GSH group and Huangqi group were lower than control group(P<0.05),there were not significantly different between the two groups(P>0.05);In GSH and Huangqi groups,however,blood serum SOD and MDA were not significantly different before and after ESWL(P>0.05),moreover,the change rang was lower than other three groups(P<0.05);It was not significantly different of GSH-Px between GSH group,GSH and Huangqi group(P>0.05),however,it was higher after than before ESWL(P<0.05),the GSH-Px was not significantly different between other two groups(P>0.05);The rang of increase of NAG/ creatinine in urine was lower than the other three groups in GSH and Huangqi group(P<0.05),moreover,NAG/ creatinine levels recovered to normal in 4 days,but the other three groups need 7 days.Conclusion It has the same effects on ESWL-induced renal injury as reduced glutathione as Astragalus membranaceus,but it is more effective during association medication.更多还原