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维生素 E 对治疗耐药革兰氏阴性菌感染时黏菌素诱导的肾毒性的影响:一项随机临床试验。

The effects of vitamin E on colistin-induced nephrotoxicity in treatment of drug-resistant gram-negative bacterial infections: A randomized clinical trial.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Infectious Disease and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Infect Chemother. 2021 Aug;27(8):1181-1185. doi: 10.1016/j.jiac.2021.03.013. Epub 2021 Apr 15.

Abstract

INTRODUCTION

Nephrotoxicity remains a major long-standing concern for colistin, and it is critical to find agents that can prevent it. The present study aims to investigate the effect of vitamin E on the prevention of colistin-induced nephrotoxicity based on its antioxidant and free radical scavenging properties.

METHODS

A randomized clinical trial was designed for 52 patients taking colistin. These patients were categorized into two groups of equal size, receiving colistin or colistin plus vitamin E (α-Tocopherol). Vitamin E with doses of 400 units was administrated daily either orally or by a nasogastric tube if needed. The incidence of Acute Kidney Injury (AKI) and its duration was recorded based on RIFLE criteria.

RESULTS

The Incidence of AKI based on RIFLE criteria was 42.3% and 46.2% in intervention and control groups, respectively. The analysis showed no significant difference in the prevalence of AKI for the two groups (P = 0.78). There was no significant difference in the duration of AKI neither (P = 0.83).

CONCLUSION

Although vitamin E is a powerful biological antioxidant, the effects of Vitamin E prophylaxis on colistin-induced nephrotoxicity was not taken into consideration in this study.

摘要

简介

肾毒性仍然是黏菌素的一个主要长期存在的问题,寻找可以预防它的药物至关重要。本研究旨在基于其抗氧化和自由基清除特性,研究维生素 E 对预防黏菌素诱导的肾毒性的影响。

方法

设计了一项针对 52 名接受黏菌素治疗的患者的随机临床试验。这些患者分为两组,每组各有相同数量的患者,一组接受黏菌素治疗,另一组接受黏菌素加维生素 E(α-生育酚)治疗。维生素 E 的剂量为 400 单位,每天口服或通过鼻胃管给予,如果需要的话。根据 RIFLE 标准记录急性肾损伤 (AKI) 的发生率及其持续时间。

结果

根据 RIFLE 标准,干预组和对照组 AKI 的发生率分别为 42.3%和 46.2%。分析显示两组 AKI 的患病率无显著差异(P=0.78)。AKI 的持续时间也没有显著差异(P=0.83)。

结论

尽管维生素 E 是一种强大的生物抗氧化剂,但本研究没有考虑维生素 E 预防黏菌素诱导的肾毒性的作用。

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