摘要
目的评价在充分水化基础上碳酸氢钠(Sodium Bicarbonate,SB)联合N-乙酰半胱氨酸(N-acetylcysteine,NAC)对慢性肾脏病(Chronic Kidney Disease,CKD)的冠状动脉粥样硬化性心脏病(简称冠心病)(Coronary Heart Disease,CHD)患者减少造影剂肾病(Contrast-Induced Nephropathy,CIN)的作用。方法随机选取2020年8月-2022年7月在广西壮族自治区民族医院行经皮冠状动脉介入治疗(Percutaneous Coronary Interven⁃tions,PCI)的120例CKD患者为研究对象,使用随机数表法分为常规治疗组(NS组)、碳酸氢钠(SB组)、乙酰半胱氨酸组(NAC组)、碳酸氢钠联合乙酰半胱氨酸组(SB+NAC组),每组30例。NS组于PCI术前给予持续水化治疗;SB组在NS组基础上给予SB;NAC组在NS组基础上于术前和术后口服N-乙酰半胱氨酸泡腾片。SB+NAC组在SB组基础上同NAC组处理。分析4组患者在术前及PCI术后48 h血清指标血肌酐(Serum Cre⁃atinine,SCr)、胱抑素C(Cystatin C,Cys-C),计算肌酐清除率(Creatinine Clearance Rate,Ccr),估算记录肾小球滤过率(Estimated Glomerular Filtration Rate,eGFR)。结果NS组、SB组、NAC组、SB+NAC组患者术后eGFR、Ccr、SCr、Cys-C比较,差异有统计学意义(P均<0.05)。NS组、SB组、NAC组、SB+NAC组患者发生CIN例数分别为7例、5例、3例、0,4组患者CIN发生率比较,差异有统计学意义(χ^(2)=8.152,P<0.05)。结论水化基础上碳酸氢钠、N-乙酰半胱氨酸以及两者联合应用有效减少CKD患者行PCI术后CIN的发生,具有一定效果,且两种药物联合应用要优于单独应用。
Objective To evaluate the effect of sodium bicarbonate(SB)combined with N-acetylcysteine(NAC)on reducing contrast-induced nephropathy(CIN)in patients with coronary heart disease(CHD)with chronic kidney disease(CKD)on the basis of adequate hydration.Methods A total of one hundred and twenty patients with CKD who under-went percutaneous coronary interventions(PCI)in Guangxi Zhuang Autonomous Region Ethnic Hospital from August 2020 to July 2022 were randomly selected as the research objects.They were divided into conventional treatment group(NS group),sodium bicarbonate(SB group),acetylcysteine group(NAC group)and sodium bicarbonate com-bined acetylcysteine group(SB+NAC group)by random number table method,with thirty cases in each group.NS group was given continuous hydration treatment before PCI;SB group was given SB on the basis of NS group;In NAC group,N-acetylcysteine effervescent tablets were taken orally before and after surgery on the basis of NS group;SB+NAC group was treated with NAC group on the basis of SB group.Serum indexes of serum creatinine(SCr)and cys-tatin C(Cys-C)in 4 groups were analyzed before surgery and 48 h after PCI.Calculated creatinine clearance(Ccr)and estimated glomerular filtration rate(eGFR)were calculated and recorded.Results There were statistically signifi-cant differences in eGFR,Ccr,SCr and Cys-C in NS group,SB group,NAC group and SB+NAC group(all P<0.05).The number of CIN cases in NS group,SB group,NAC group and SB+NAC group were 7,5,3 and 0,there was statisti-cally significant differences in CIN in the 4 groups(χ^(2)=8.152,P<0.05).Conclusion Based on hydration,sodium bicar-bonate,N-acetylcysteine and their combination can effectively reduce the occurrence of CIN after PCI in CKD pa-tients,and the combination of the two drugs is better than the single application.
作者
雷玲艳
邝日禹
李依阳
覃凯
耿思远
苏晓琳
LEI Lingyan;KUANG Riyu;LI Yiyang;QIN Kai;GENG Siyuan;SU Xiaolin(Department of Cardiology,Guangxi Zhuang Autonomous Region Ethnic Hospital/Guangxi Medical University Affiliated Hospital for Nationalities,Nanning,Guangxi Zhuang Autonomous Region,530001 China)
出处
《中外医疗》
2024年第4期1-4,共4页
China & Foreign Medical Treatment
基金
广西壮族自治区卫生和计划生育委员会科研课题(Z2019068)。
