摘要
目的探讨还原型谷胱甘肽添加治疗Wilson病(WD)神经系统症状的疗效及对氧化应激水平的影响。方法将60例有神经系统损害症状的WD患者随机分为谷胱甘肽组及对照组,每组30例。对照组行驱铜治疗和低铜饮食,谷胱甘肽组在此基础上加用还原型谷胱甘肽(0.9-1.8 g/d),治疗4周。于治疗前后分别行改良Young量表评分评价神经功能,检测血清总抗氧化能力(TAC)、丙二醇(MDA)、谷丙转氨酶(ALT)、天冬氨酸转移酶(AST)及24 h尿铜水平。结果与治疗前比较,治疗后谷胱甘肽组及对照组改良Young量表评分及MDA、ALT、AST水平均降低(均P<0.05),TAC、24 h尿铜水平显著升高(均P<0.05)。与对照组比较,谷胱甘肽组治疗前Young量表评分及TAC、MDA、24 h尿铜、ALT、AST水平差异无统计学意义(均P>0.05)。与对照组相比,谷胱甘肽组治疗后改良Young量表评分及MDA、ALT水平明显下降(均P<0.05),TAC、24 h尿铜水平显著升高(均P<0.05),AST水平差异无统计学意义(P>0.05)。结论还原型谷胱甘肽可加强排铜效果,提高抗氧化应激水平,改善WD患者的神经系统症状,安全性较高。
Objective To investigate the effect of reduced glutathione on Wilson’s disease(WD) with neurological symptoms and oxidative stress. Methods Sixty WD patients with nervous system impairment were randomly divided into glutathione group and control group, 30 cases in each group. The control group was treated with low copper diet and copper excretion, while the glutathione group plus reduced glutathione(0.9-1.8 g/d) for 4 weeks. The neural function was evaluated by the modified Young scale before and after treatment. The levels of serum total antioxidant capacity(TAC), propylene glycol(MDA), alanine transaminase(ALT), aspartate aminotransferase(AST) and 24 h urine copper were measured before and after treatment. Results Compared with those before treatment, modified Young scale score, and MDA, ALT, AST levels in glutathione group and control group after treatment were significantly decreased(all P<0.05), and levels of TAC and 24 h urine copper were significantly increased(all P<0.05). Compared with those in control group, there were no significant differences in modified Young scale score and levels of TAC, MDA, 24 h urine copper, ALT, AST levels in glutathione group before treatment(all P>0.05). Compared with those in control group, modified Young scale score and the levels of MDA, ALT in glutathione group after treatment were significantly decreased(all P<0.05), and the levels of TAC and 24 h urine copper were significantly increased(all P<0.05), while no significant difference between the two groups in the level of AST(P>0.05). Conclusion Reduced glutathione can enhance the effect of copper excretion, increase the level of antioxidant stress and improve the neurological symptoms of WD patients without obvious adverse reactions.
作者
李良勇
吴云虎
李亚军
杨文明
LI Liang-yong;WU Yun-hu;LI Ya-jun(Department of Neurology,Anhui Unit ersily of Chinese Medicine,Hefei 230031,China)
出处
《临床神经病学杂志》
CAS
2020年第4期262-265,共4页
Journal of Clinical Neurology
基金
安徽省自然科学基金项目(1908085MH250)。
