还原性谷胱甘肽对造影剂肾病预防作用的临床研究

Protective effects of reduced glutathione on contrast induced nephropathy

目的:探讨还原性谷胱甘肽在预防造影剂肾病发生的作用。方法:采用前瞻性临床对照研究的方法,将160例择期接受冠状动脉造影术和(或)PCI的冠心病患者随机分为治疗组(100例)和对照组(60例),治疗组给予还原性谷胱甘肽联合水化预防方案,对照组仅给予水化,比较两组患者肾功能指标的变化和CIN发生风险。结果:造影后治疗组血清Cys-c水平显著低于对照组(1.10±0.28vs1.29±0.32,t=2.451,P=0.035)。在纳入的研究对象中,11例符合CIN诊断标准,总体发生率为6.88%。其中治疗组和对照组CIN的发生率分别为3.00%和13.33%,差异具统计学意义(χ2=4.744,P=0.029)。结论:冠状动脉介入诊疗患者具有较高的CIN发生风险,应用还原性谷胱甘肽联合水化可在一定程度上降低CIN发生风险。

Objective To investigate the protective effects of reduced glutathione on contrast induced nephropathy （C/N）. Methods 160 patients with coronary heart disease who received diagnostic coronary angiography or percutaneous coronary intervention were randomly divided into treatment group （n = 100） and control group （n = 60）. Patients in treatment group received reduced glutathione and hydration prevention, and those in control group only received hydration. Renal function indexes and CIN at risk of the two groups were compared. Results Serum Cys-c level in treatment group was significantly lower than that in control group （ 1.10 ± 0.28 vs. 1.29 ± 0.32, t = 2.451, P = 0.035）. The diagnosis of CIN in 11 patients was accord with standard, and the overall occurrence was 6.88%. The incidence of CIN in treatment group and control group was 3.00% and 13.33% （χ2 = 4.744, P = 0.029）. Conclusion There was high risk for CIN in patients receiving coronary intervention; preoperative application of reduced glutathione and hydration can reduce the risk of CIN to some degrees.