曲美他嗪对肾功能不全患者对比剂肾病的预防作用

目的：探讨肾功能不全患者应用曲美他嗪（TMZ）预防对比剂肾病（CIN）的临床疗效。方法：本研究为前瞻性随机对照临床试验，连续入选124例拟行冠状动脉造影或冠状动脉介入术患者，基础血清肌酐（Scr）＞103μoml/L，随机分为2组：TMZ组（n=64）和对照组（n=60）。TMZ组于造影前48 h给予TMZ片20 mg，每天3次，术后服用7 d。所有患者均于术前及术后接受常规水化治疗，观察患者术前、术后24 h、48 h、7 d的Scr水平。结果：①2组患者术后24 h Scr水平差异无统计学意义（P＞0.05）；②TMZ组术后48 h、7 d的Scr水平明显低于对照组（P＜0.05）；③TMZ组CIN的发生率为3.1%，对照组为16.7%，2组比较差异有统计学意义（P＜0.05）。结论：TMZ联合水化治疗与单独水化治疗相比，能减少肾功能不全患者CIN的发生率。

Prevention of contrast-induced nephropathy with trimetazidine in patients with renal insufifciency

Objective： To evaluate the efficacy of trimetazidine （TMZ） in the prevention of contrast-induced nephropathy （CIN） in patients with renal insufifciency. MethodWe conducted a prospective, random-ized, controlled trial, 124 patients undergoing coronary angiography/angioplasty were involved, whose stable serum creatinine levels were at least 103μoml/L. They were divided into TMZ group （n=64） and control group （n=60） randomly, TMZ group received TMZ （20 mg thrice daily） orally for 7 d starting 48 h before the procedure. All patients were given routine hydration treatment before and after the procedure. Serum creatinine （Scr） levels were measured before the procedure, 24 h, 48 h and 7 d after the procedure. Result①Scr levels had no statisti-cal signiifcance in the two groups 24 h after the procedure （P＆gt;0.05）.②Scr levels signiifcantly decreased after 48 h and 7 d in the TMZ group （P＆lt;0.05）.③CIN developed in 3.1%of patients in the TMZ group and in 16.7%of patients in the control group （P＆lt;0.05）. Conclusion：TMZ along with isotonic saline hydration is more effective than isotonic saline alone in reducing the risk of CIN in patients with renal insufifciency.