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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 investigate the efficacy of trimetazidine in the prevention of contrast-induced nephropathy in patients with renal insufficiency. Methods: From April 2010 to March 2014, 100 patients with renal insufficiency who underwent coronary angiography in our department were randomly divided into study group (50 cases) and control group (50 cases). The study group received hydration therapy + trimetazidine The control group received only hydration therapy. The changes of serum creatinine (Scr), superoxide dismutase (SOD) and the occurrence of contrast-induced nephropathy were compared between the two groups before and 1 d, 3 d and 7 d after operation Number of cases. Results: The preoperative and postoperative levels of the study group showed an overall downward trend in the Scr level. The Scr level on the 7th day postoperatively was significantly lower than that before the operation. The level of Scr in the control group was significantly higher than that before the operation, The level of Scr on the 7th day was somewhat lower than the preoperative level. The postoperative SOD level of the study group showed an overall upward trend, and the levels of SOD on the 3rd and 7th postoperative days were significantly higher than those before the operation. The SOD level in the control group showed no significant difference after the operation. The incidence of contrast nephropathy in the study group was significantly lower than that in the control group (4 vs 9, P <0.05). Conclusion: Coronary angiography in patients with renal insufficiency, while giving hydration therapy and oral trimetazidine more than simple hydration therapy to prevent contrast agent nephropathy.