水化治疗联合乙酰半胱氨酸预防冠心病并糖尿病患者发生造影剂肾病的临床研究

目的探讨水化治疗联合乙酰半胱氨酸（N—Acetyl—L—cysteine，NAC）对冠心病并糖尿病患者发生造影剂肾病（contrast—induced nephropathy，CIN）的防治作用。方法选择接受冠状动脉介入诊疗的冠心病并糖尿病患者96例，随机分为水化治疗联合NAC研究组55例和常规治疗对照组41例。检测所有患者术前3天（任意一天）、术后第1天、第2天、第3天、第6天的血清肌酐水平。结果术后第1、2、3、6天对照组较研究组血清肌酐均明显增高，差异有统计学意义（P〈0．05）。研究组发生CIN1例（1．82％），对照组发生CIN8例（19．51％），两组对比差异有高度统计学意义（P〈0．01）。结论水化治疗联合NAC较常规治疗可显著减少CIN的发生。

The effects of hydration combined with N-acetylcysteine therapy for pre- vention of contrast-induced nephropathy after cardiac catheterization in patients with coronary heart disease complicated with diabetes mellitus

Objective To investigate the effects of hydration combined with N-acetylcysteine therapy for prevention of contrast-induced nephropathy（CIN） after cardiac catheterization in patients with coronary heart disease complicated with diabetes mellitus. Methods A total of 96 patients with coronary heart disease complicated with diabetes mellitus that underwent interventional therapy were enrolled and randomLy divided into treatment group 55 cases and contrast group 41 cases. Treatment group was treated with hydration combined with N-acetylcysteine therapy,while the contrast group was given conventional therapy.Serum creatinine levels of the two groups before cardiac catheterization and 1,2,3,6 days after cardiac catheterization were measured and compared. Results There was significant less increase in serum creatinine levels of the treatment group compared with the contrast group 1,2,3,6 days after cardiac catheterization（P 〈 0.05）.The occurrence of CIN was a greater decrease in the treatment group compared with the contrast group after cardiac catheterization （P 〈 0.01 ）. Conclusion The hydration combined with N-acetylcysteine therapy for prevention of CIN after cardiac catheterization in patients with coronary heart disease complicated with diabe-tesmellitus is safe and simple,it can effectively prevent CIN.