n -乙酰半胱氨酸对抗菌素引起的肾毒性的影响：一项荟萃分析。

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

BMC Nephrology Pub Date : 2025-03-08 DOI:10.1186/s12882-025-04037-y

Xianming Qiu, Shenao Yang, Yuke Zhang, Quanzhen Wang, Li Kong, Lei Zhou

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引用次数: 0

摘要

目的：n -乙酰半胱氨酸（NAC）具有减轻急性肾损伤的抗氧化作用。本研究系统地回顾和评估了NAC在预防抗菌素引起的肾毒性方面的疗效。方法：截至2024年6月1日，广泛检索Pubmed， Embase， Web of Science和Cochrane Library，以评估NAC对抗菌药物引起的肾毒性的相关研究。根据纳入和排除标准筛选符合条件的记录。采用比值比（OR）评价NAC对肾毒性的影响。我们使用随机效应模型汇总了提取的数据。结果：分析纳入3个随机对照试验。综合结果显示，NAC可降低抗微生物药物肾毒性的发生率（OR = 0.487, 95% CI = 0.258, 0.918, P = 0.03, I2 = 0%）。与安慰剂组相比，NAC组第2天血清肌酸（Scr）显著降低(SMD, - 0.298；95%CI, - 0.585 ~ - 0.010；i2 = 23%；p = 0.04)。血尿素氮（BUN）和肌酐清除率（CrCl）无显著差异。结论：在这项荟萃分析中，NAC与预防抗菌素引起的肾毒性相关。然而，未来需要大规模和精心设计的随机对照试验。

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Effect of N-acetylcysteine on antimicrobials induced nephrotoxicity: a meta-analysis.

Objective: N-acetylcysteine (NAC) has antioxidant effects in reducing acute kidney injury. This study systematically reviewed and assessed the efficacy of NAC in preventing antimicrobials induced nephrotoxicity.

Methods: Pubmed, Embase, Web of Science, and the Cochrane Library were searched extensively for relevant studies that evaluating NAC on antimicrobials induced nephrotoxicity until June 1, 2024. Eligible records were screened according to the inclusion and exclusion criteria. The odds ratio (OR) was selected to evaluate the effect of NAC on nephrotoxicity. We pooled the extracted data using a random effects model.

Results: Three randomized controlled trials were included in the analysis. The pooled results showed that NAC could reduce the incidence of antimicrobials induced nephrotoxicity (OR = 0.487, 95% CI = 0.258, 0.918, P = 0.03, I² = 0%). Serum creatine (Scr) on Day 2 was significantly decreased in the NAC group compared to the placebo group (SMD, - 0.298; 95%CI, - 0.585 to - 0.010; I² = 23%; P = 0.04). No difference was observed in blood urea nitrogen (BUN), and creatinine clearance (CrCl).

Conclusion: In this meta-analysis, NAC was associated with a benefit in the prevention of antimicrobials induced nephrotoxicity. However, large-scaled and well-designed RCTs are required in the future.

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来源期刊

BMC Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.30

自引率

0.00%

发文量

375

审稿时长

3-8 weeks

期刊介绍： BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.