N-乙酰半胱氨酸对造影剂肾病预防效果的系统评价

A Meta Analysis of the Prevention of Contrast-induced Nephropathy Using N-acetylcysteine

目的系统评价N-乙酰半胱氨酸(NAC)对造影剂肾病(contrast induced nephropathy,CIN)的预防效果。方法检索1994～2011年PuMed数据库、万方数据库及中国知网,按Cochrane Handbook for Systematic Reviews ofIntervention质量评价标准,用Review Manager 5.1软件对符合质量标准的随机对照试验(RCT)文献进行Meta分析。结果本研究初步检索出168篇相关文献,有13篇RCT文献入选,共纳入患者1533例,单纯水化组770例,水化+NAC组763例。结果显示在水化治疗的基础上应用NAC,与单纯水化比较差异有统计学意义[OR=0.46,95%CI(0.34,0.62)]。结论在水化基础上应用NAC预防CIN效果显著。

Objective The objective of this study was to assess the effectiveness of N-acetylcysteine for prevention of contrast induced nephropathy.Methods We searched Pubmed,Wanfang and CNKI databases for trials using N-acetylcysteine to prevent contrast-induced nephropathy during 1994 and 2011.Meta-analysis was conducted for the eligible RCT.Results A total of 13 trials and 1533 subjects were pooled.This updated meta-analysis found N-acetylcysteine to be useful for the prevention of contrast-induced nephropathy.And further analysis showed that N-acetylcysteine with hydration group（n=763） was more useful than only hydration group（n=770） with significant difference.Conclusion N-acetylcysteine has been found to be useful in the prevention of contrast-induced nephropathy.And N-acetylcysteine with hydration is more effective than placebo with hydration.