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目的探讨乙酰半胱氨酸(N-Acetyl-L-cysteine,NAC)联合水化治疗对老年冠心病并糖尿病患者发生造影剂肾病(contrast-induced nephropathy,CIN)的防治作用。方法选择接受冠状动脉介入诊疗的老年冠心病并糖尿病患者87例,随机分为NAC联合水化的研究组46例和常规治疗的对照组41例,检测所有患者术前3d(任一天)、术后第1d、第3d、第6d的血清肌酐水平。结果术后第1、3、6d对照组较研究组血清肌酐均明显增高,差异有统计学意义,P均<0.05。研究组46例发生CIN 1例(2.17%),对照组41例发生CIN 9例(21.95%),两组对比有显著性差异(P<0.01)。结论 NAC联合水化较常规治疗可显著减少CIN的发生。
Objective To investigate the preventive and therapeutic effects of N-Acetyl-L-cysteine (NAC) combined with hydration on contrast-induced nephropathy (CIN) in elderly patients with coronary heart disease and diabetes mellitus. Methods Eighty-seven elderly patients with coronary heart disease and diabetes mellitus undergoing coronary intervention were randomly divided into NAC combined hydration study group (n = 46) and routine treatment control group (n = 41). All patients underwent preoperative 3d (any one day) After 1d, 3d, 6d serum creatinine level. Results The serum creatinine in the control group was significantly higher than that of the study group on the 1st, 3rd, 6th day after operation, the difference was statistically significant (P <0.05). CIN was found in 46 cases (2.17%) in the study group and 9 cases (21.95%) in the control group. There were significant differences between the two groups (P <0.01). Conclusion NAC combined with hydration can significantly reduce the occurrence of CIN.