【摘要】 目的 探讨还原型谷胱甘肽联合血液灌流对脓毒性休克患者疗效及多脏器功能的保护作用。方法 选取120例严重脓毒症患者，随机数字表法分为对照组(60例)和观察组(60例)，对照组进行血液灌流治疗，观察组在对照组基础上联合还原型谷胱甘肽，比较两组治疗前后APACHE II评分、SOFA评分，ICU住院天数及28 d死亡率；比较两组治疗前后血清乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)，天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)，血尿素氮(BUN)、血肌酐(Scr)、胃泌素(GAS)，胃动素(MTL)水平。结果与治疗前比较，两组患者治疗后APACHE II评分、SOFA评分、血清LDH、CK-MB、cTnI、AST、ALT、BUN、Scr、GAS降低，MTL升高(P<0.05)；与对照组比较，观察组治疗后APACHE II评分、SOFA评分、血清LDH、CK-MB、cTnI、AST、ALT、BUN、Scr、GAS水平，ICU住院天数、28 d死亡率降低，治疗后MTL升高(P<0.05)。结论 还原型谷胱甘肽联合血液灌流对脓毒性休克患者，可改善心、肝、肾及胃肠道等脏器损伤，具有良好临床效果。更多还原

【Abstract】 Objective To explore the therapeutic effect of reduced glutathione combined with hemoperfusion on patients with septic shock and the protective effect of multiple organ functions.Methods 120 patients with severe sepsis were selected and divided into a control group(60 cases) and an observation group(60 cases) according to random number table method. The control group was treated with hemoperfusion, and the observation group was combined with reduced glutathione on the basis of the control group. Compared the two groups before and after treatment APACHE II score,SOFA score, ICU hospitalization days and 28-day mortality. Compared the two groups before and after treatment serum lactate dehydrogenase(LDH), creatine kinase MB(CK-MB), cardiac troponin I(cTnI), aspartate aminotransferase(AST), alanine aminotransferase(ALT), blood urea nitrogen(BUN), serum creatinine(Scr), gastrin(GAS), motilin(MTL)levels.Results Compared with before treatment, APACHE II score, SOFA score, serum LDH, CK-MB, cTnI, AST,ALT, BUN, Scr, GAS decreased, and MTL increased after treatment in two groups(P<0.05). Compared with the control group, APACHE II score, SOFA score, serum LDH, CK-MB, cTnI, AST, ALT, BUN, Scr, GAS levels, ICU hospitalization days, 28-days mortality rate decreased, and MTL increased after treatment in observation group(P<0.05).Conclusion Reduced glutathione combined with hemoperfusion can improve heart, liver, kidney and gastrointestinal organ damage in patients with septic shock, and has good clinical effects.更多还原