Does N-acetyl-L-cysteine influence cytokine response during early human septic shock?
Does N-acetyl-L-cysteine influence cytokine response during early human septic shock?
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DOI：
10.1378/chest.113.6.1616
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发表时间：
1998-06-01
期刊：
影响因子：
9.6
通讯作者：
Huyghens, L
中科院分区：
文献类型：
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作者：
Spapen, H;Zhang, HB;Huyghens, L
研究目的：评估N-乙酰-L-半胱氨酸（NAC）连续治疗对感染性休克患者血流动力学、氧转运变量和血浆细胞因子水平的影响。设计：前瞻性、随机、双盲、安慰剂对照研究。设置：一所大学医院的24床内科外科ICU。患者：22名患者在感染性休克诊断后4小时内入选。干预措施：患者被随机分配接受NAC或（150 mg/kg推注，随后在4 h内连续输注50 mg/kg; n = 12）或安慰剂（n = 10）。肿瘤坏死因子-α（TNF）、白细胞介素（IL）-6、IL-8、IL-10和可溶性肿瘤坏死因子-α受体-p55的血浆浓度在0、2、4、6和24 h通过灵敏的免疫测定法测量sTNFR-p55，在基线、输注后（4 h）和24 h测量肺动脉导管衍生的血流动力学、血气、血红蛋白和动脉乳酸。NAC改善氧合（PaO 2/FIo（2）比值，214+/-97 vs 123+/-86; p
Study objective: To assess the effects of adjunctive treatment with N-acetyl-L-cysteine (NAC) on hemodynamics, oxygen transport variables, and plasma levels of cytokines in patients with septic shock.Design: Prospective, randomized, double-blind, placebo-controlled study.Setting: A 24-bed medicosurgical ICU in a university hospital.Patients: Twenty-two patients included within 4 h of diagnosis of septic shock.Interventions: Patients were randomly allocated to receive either NAC (150 mg/kg bolus, followed by a continuous infusion of 50 mg/kg over 4 h; n = 12) or placebo (n = 10) in addition to standard therapy.Measurements: Plasma concentrations of tumor necrosis factor-alpha (TNF), interleukin (IL)-6, IL-8, IL-10, and soluble tumor necrosis factor-alpha receptor-p55 (sTNFR-p55) were measured by sensitive immunoassays at 0, 2, 4, 6 and 24 h, Pulmonary artery catheter-derived hemodynamics, blood gases, hemoglobin, and arterial lactate were measured at baseline, after infusion (4 h), and at 24 h.Results: NAC improved oxygenation (PaO2/FIo(2) ratio, 214+/-97 vs 123+/-86; p