摘要
目的探讨N-乙酰半胱氨酸对老年患者碘海醇肾损害的保护作用。方法选取行增强CT检查(静脉注射碘造影剂碘海醇)的老年患者74例,其中A组26例(于造影前48h和造影后48h口服N-乙酰半胱氨酸600mg,2次/d),B组25例(于造影前48h和造影后48h口服N-乙酰半胱氨酸600mg,1次/d);对照组23例(于造影前48h和造影后48h口服安慰剂,1次/d)。造影前和造影后48h,检测3组患者血尿素氮(BUN)、SCr、内生肌酐清除率(CCr),并记录对比剂肾病发生率,造影前和造影后48h以及5d时,检测24h尿蛋白(PRO)、24h尿β2-微球蛋白(β2-MG)、24h尿微量白蛋白(UmAlb)。结果 A组无CIN发生,B组发生CIN5例(20%),C发生CIN6例(26.09%),A组CIN发生率明显低于B、C组(均P<0.05)。3组患者造影前各指标的差异均无统计学意义(P>0.05)。与造影前比较,3组患者造影后48h BUN、SCr、Ccr均发生明显变化(P<0.05);与B组、对照组比较,A组造影后48h BUN、SCr、Ccr均发生明显变化(P<0.05)。与造影前比较,3组患者造影后48h、5d时PRO、Umalb、和β2-MG均发生明显变化(P<0.05);与对照组比较,A组造影后48h及5d、B组造影后48h的PRO、Umalb、和β2-MG均发生明显变化(P<0.05)。结论口服N-乙酰半胱氨酸600mg(2次/d)能有效预防老年患者碘海醇肾损害。
Objective To investigate the protective effect of N-acetyl cysteine on renal function in elderly patients under- going contrast-enhanced CT scan by using iohexol. Methods Seventy four elderly patients undergoing contrast-enhanced CT scan using iohexol injection were randomly divided into three groups： group A （n=26） received oral N- acetyl cysteine 600mg, 2/d, 48h before and 48 after scanning; group B （n=25） received oral N- acetyt cysteine 600mg, 1/d, 48h before and 48h after the scanning; group C （control group, n=23） received oral placebo, 1/d, 48h before and 48h after the scanning. Blood urea nitrogen （BUN） and creatinine （SCr） were measured 48h before and 48h after CT examination; 24h urinary protein （PRO）, beta-2 mi- croglobulin （ β 2 MG ）, urinary micro albumin （UmAIb） and other indicators were measured 48h before and 48h, 5d after CT ex- amination. Results There were no case of contrast-induced nephropathy （CIN）in group A, 5 cases in group B and 6 cases in group C, the incidence rate of CIN in group A （0.0%） was significantly lower than that in group B （20.0%） and C （26.1%） （P〈 0.05）. Conclusion Oral administration of N-acetyl cysteine （600 mg, 2/d） can effectively prevent renal function in elderly patients undergoing contrast-enhanced CT scan by using iohexol.
出处
《浙江医学》
CAS
2013年第14期1345-1347,共3页
Zhejiang Medical Journal
基金
杭州市卫生科技计划项目(2009B075)
