曲美他嗪预防肾功能不全患者造影剂肾病的临床研究

Clinical Study of Prevention Effect of Trimetazidine in Renal Insufficiency Patients with Contrast Nephropathy

目的:探讨曲美他嗪预防肾功能不全患者造影剂肾病的疗效。方法:将2010年4月-2014年3月我科收治的拟行冠脉造影的肾功能不全患者100例随机分为研究组和对照组各50例,研究组行水化治疗+曲美他嗪口服治疗,对照组仅接受水化治疗,比较两组术前、术后1 d、3 d、7 d血肌酐(Scr)、超氧化物歧化酶(SOD)的变化及发生造影剂肾病的例数。结果:研究组术前与术后比较,Scr水平呈整体下降趋势,术后7 d的Scr水平显著低于术前;对照组术前与术后3 d比较,Scr水平显著升高,术后7 d的Scr水平有所回落,但仍高于术前水平。研究组术后SOD水平呈整体上升趋势,且术后3 d、7 d的SOD水平均显著高于术前;对照组的SOD水平在术前术后的变化无统计学差异。研究组造影剂肾病的发生例数明显低于对照组(4 VS 9,P<0.05)。结论:肾功能不全患者行冠脉造影时,同时给予水化治疗及口服曲美他嗪较单纯水化治疗更能预防造影剂肾病。

Objective：To explore the effect of Trimetazidine preventing contrast media-induced nephropathy in patients with renal insufficiency. Method：100 renal insufficiency patients who were going to do coronary angiography were randomly divided into research group （n=50） and control group （n=50） from Apr 2012 to March 2014. The research group was received hydration therapy and trimetazidine oral therapy , while the control group was received only hydration treatment. Before coronary angiography,1 day,3 days,7 days after coronary angiography,serum creatinine （Scr）, superoxide dismutase （SOD） and the number of contrast-induced nephropathy were compared between the two groups. Results：Scr level decreased after coronary angiography in research group , while which increased in 3 days and 7 days after coronary angiography and then decreased in the control group. SOD level increased after coronary angiography in research group. Yet it remained the same in the control group both 3 days and 7 days after coronary angiography. The contrast media-induced nephropathy cases happened in research group was significantly lower than that in the control group （ 4 VS 9,P〈0.05）. Conclusion： Comparing with the only hydration treatment,combined with Trimetazidine can prevents contrast media-induced nephropathy effectively in patients with renal insufficiency going to do coronary angiography.