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甘露醇对接受脑死亡供体肾移植患者氧化还原电位的影响:一项随机对照试验。

The effect of mannitol on oxidation-reduction potential in patients undergoing deceased donor renal transplantation-A randomized controlled trial.

机构信息

Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria.

Clinical Department of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.

出版信息

Acta Anaesthesiol Scand. 2021 Feb;65(2):162-168. doi: 10.1111/aas.13713. Epub 2020 Oct 15.

Abstract

BACKGROUND

Mannitol, an osmotic diuretic, is proposed to be an oxygen radical scavenger. Mannitol is often used in renal transplantation to attenuate oxidative stress and thus to protect renal graft function. We tested the hypothesis that mannitol reduces overall oxidative stress during deceased donor renal transplantation.

METHODS

We randomly assigned 34 patients undergoing deceased donor renal transplantation to receive a solution of mannitol or placebo shortly before graft reperfusion until the end of surgery. We evaluated oxidative stress by measuring the static oxidative-reduction potential (sORP) and the capacity of the oxidative-reduction potential (cORP). sORP and cORP were measured pre-operatively, before and within 10 minutes after graft reperfusion, and post-operatively.

RESULTS

Seventeen patients were enrolled in the mannitol group and 17 patients were enrolled in the placebo group. Mannitol had no significant effect on sORP (148.5 mV [136.2; 160.2]) as compared to placebo (143.6 mV [135.8; 163.2], P = .99). There was also no significant difference in cORP between the mannitol (0.22 µC [0.16; 0.36]) and the placebo group (0.22 µC [0.17; 0.38], P = .76).

CONCLUSION

Mannitol showed no systemic redox scavenging effects during deceased donor renal transplantation. To evaluate the direct effect of mannitol on the renal graft further studies are needed.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02705573.

摘要

背景

甘露醇是一种渗透性利尿剂,据推测它是一种氧自由基清除剂。甘露醇常用于肾移植中,以减轻氧化应激,从而保护移植肾的功能。我们假设在尸体供肾移植中,甘露醇可降低整体氧化应激,因此进行了此项研究。

方法

我们将 34 例行尸体供肾移植的患者随机分为甘露醇组或安慰剂组,两组患者在再灌注前即刻至手术结束时分别输注甘露醇或安慰剂。我们通过测量静态氧化还原电位(sORP)和氧化还原能力(cORP)来评估氧化应激。在术前、再灌注前及再灌注后 10 分钟内及术后进行 sORP 和 cORP 的测量。

结果

17 例患者纳入甘露醇组,17 例患者纳入安慰剂组。与安慰剂相比,甘露醇对 sORP 无显著影响(148.5 mV[136.2;160.2] 比 143.6 mV[135.8;163.2],P=0.99)。甘露醇组(0.22 µC[0.16;0.36])与安慰剂组(0.22 µC[0.17;0.38],P=0.76)之间的 cORP 也无显著差异。

结论

在尸体供肾移植中,甘露醇没有显示出系统的氧化还原清除作用。为了进一步评估甘露醇对移植肾的直接作用,需要进行更多的研究。

试验注册

ClinicalTrials.gov NCT02705573。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c134/7821012/1b8278a5f767/AAS-65-162-g001.jpg

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