应用N-乙酰半胱氨酸对冠心病合并糖尿病的患者发生造影剂肾病的预防作用

目的探讨N-乙酰半胱氨酸（NAC）对冠心病合并糖尿病的患者发生造影剂肾病的预防作用。方法选取行冠脉造影或介入治疗的合并糖尿病的冠心病患者80例,随机分为对照组、NAC组。对照组给予0.9%生理盐水水化治疗,NAC组联合水化治疗给予NAC口服,比较造影前、造影后48 h、5 d血肌酐（SCr）、尿素氮（BUN）、尿β2微球蛋白（β2-MG）、尿N-乙酰β-氨基葡萄糖苷酶（NAG）及造影剂肾病发生率等。结果 NAC组造影后SCr、BUN、β2-MG、NAG等指标优于对照组,差异存在统计学意义（P〈0.05）。结论对合并糖尿病的冠心病患者NAC联合水化治疗预防造影剂肾病优于生理盐水水化治疗。

Preventive Effect of N-acetylcysteine on Contrast-induced Nephropathy in Patients with Coronary Heart Disease with Type 2 Diabetes Mellitus

Objective To study whether N-acetylcysteine（NAC） could prevent contrast-induced nephropathy（CIN）in patients with coronary heart disease（CHD） with Type 2 Diabetes Mellitus（DM）.Methods 80 patients with CHD with DM received coronary angiography（CAG） or PCI were randomly divided into the NAC group and the control group.All patients received hydration treatment,and the NAC group received NAC as the same time.The rate of CIN and serum urea nitrogen and creatinine,and urine β2-microglobulin and urine N-acetyl-β-glucosaminidase was measured before and after 48 hours and 5 days of contrast administration.Results The patients＇ renal function in the NAC group is better than that in control group after contrast administration,which has significant difference（P0.05）.Conclusion The treatment with NAC and hydration is better than the treatment with simply hydration to prevent CIN in patients with CHD with DM.