N-乙酰半胱氨酸对中重度肾功能不全患者造影剂所致肾损害的预防作用

目的:探讨N-乙酰半胱氨酸(NAC)对中、重度肾功能不全患者CIN的预防作用。方法:67例中、重度肾功能不全患者,随机分为2组,分别接受0.9%氯化钠溶液(对照组33例)、NAC加0.9%氯化钠溶液(NAC组34例)2种预防方案;所有患者均使用碘克沙醇造影剂。记录患者术前24 h与术后24～48 h内血清肌酐(SCr)、尿素(UREA)及尿酸(UA)的浓度。结果:对照组和NAC组术前术后肾功能各项指标差异均无统计学意义,对照组术后与NAC组术后指标差异亦无统计学意义。结论:大剂量NAC联合0.9%氯化钠溶液与单独应用0.9%氯化钠溶液对中、重度肾功能不全患者造影剂肾损害的预防作用相当,均有降低造影剂性肾病发生的趋势。

To investigate the effect of oral N-acetylcysteine on preventing contrast induced nephropathy in patients with middle to heavy renal diseases

OBJECTIVE To investigate the effect of oral N-acetylcysteine(NAC)on preventing contrast induced nephropathy in patients with middle to heavy renal diseases.METHODS 67 patients with CKD 3-4 stage were randomly divided into 2 groups: 0.9% sodium chloride(control group 33),0.9% sodium chloride plus NAC(NAC group 34);All patients received iodixanol contrast agents.The Scr,UREA and UA concentration the day before and 24 h and 24-48 h after administration of the contrast agent were measured and the amount of the contrast was recorded.RESULTS There was no statistically significant difference between two groups in each index of kidney function index,and also no statistically significannt difference in post-operation index between two groups.CONCLUSION NAC concomitant with 0.9% sodium chloride solution or 0.9% sodium chloride solution used alone has a preventive effect from CIN in patient with CKD 3-4 Stage.Both groups have the tendency of reducing the incidence of contrast nephropathy.