Department of General Surgery, First People's Hospital affiliated to Huzhou University Medical College, Huzhou, China.
Department of General Surgery, Linghu People's Hospital of Nanxun District, Huzhou, China.
Shock. 2024 Jun 1;61(6):841-847. doi: 10.1097/SHK.0000000000002329. Epub 2024 Apr 26.
Objective: To investigate the protective effect and possible mechanisms of vitamin B 6 against renal injury in patients with sepsis. Methods: A total of 128 patients with sepsis who met the entry criteria in multiple centers were randomly divided into experimental (intravenous vitamin B 6 therapy) and control (intravenous 0.9% sodium chloride therapy) groups based on usual care. Clinical data, the inflammatory response indicators interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF-α), and endothelin-1 (ET-1), the oxidative stress response indicators superoxide dismutase, glutathione and malondialdehyde, and renal function (assessed by blood urea nitrogen, serum creatinine, and renal resistance index monitored by ultrasound) were compared between the two groups. Results: After 7 d of treatment, the IL-6, IL-8, TNF-α, and ET-1 levels in the experimental group were significantly lower than those in the control group, the oxidative stress response indicators were significantly improved in the experimental group and the blood urea nitrogen, serum creatinine, and renal resistance index values in the experimental group were significantly lower than those in the control group ( P < 0.05). There was no statistical difference between the two groups in the rate of renal replacement therapy and 28 d mortality ( P > 0.05). However, the intensive care unit length of stay and the total hospitalization expenses in the experimental group were significantly lower than those in the control group ( P < 0.05). Conclusion: The administration of vitamin B 6 in the treatment of patients with sepsis attenuates renal injury, and the mechanism may be related to pyridoxine decreasing the levels of inflammatory mediators and their regulation by redox stress.
探讨维生素 B6 对脓毒症患者肾损伤的保护作用及其可能机制。方法:本研究共纳入 128 例符合纳入标准的多中心脓毒症患者,按常规治疗分为实验组(静脉注射维生素 B6 治疗)和对照组(静脉注射 0.9%氯化钠治疗)。比较两组患者的临床资料、炎症反应指标白细胞介素 6(IL-6)、白细胞介素 8(IL-8)、肿瘤坏死因子(TNF-α)和内皮素-1(ET-1)、氧化应激反应指标超氧化物歧化酶、谷胱甘肽和丙二醛以及肾功能(通过超声监测血尿素氮、血清肌酐和肾阻力指数评估)。结果:治疗 7 d 后,实验组的 IL-6、IL-8、TNF-α 和 ET-1 水平明显低于对照组,实验组的氧化应激反应指标明显改善,实验组的血尿素氮、血清肌酐和肾阻力指数值明显低于对照组(P<0.05)。两组患者的肾脏替代治疗率和 28 d 死亡率差异无统计学意义(P>0.05)。然而,实验组的重症监护病房住院时间和总住院费用明显低于对照组(P<0.05)。结论:在脓毒症患者的治疗中给予维生素 B6 可减轻肾损伤,其机制可能与吡哆醇降低炎症介质水平及其对氧化应激的调节有关。