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目的:探讨N-乙酰半胱氨酸(N-acetylcysteine,NAC)用于预防老年患者碘海醇造影致肾损害的临床应用价值。方法:将2011年9月至2012年10月我院静脉注射碘海醇行增强CT检查的老年患者74例根据患者检查顺序采用随机数字表分为治疗A组(A组,n=26)、治疗B组(B组,n=25)和对照组(C组,n=23),A组患者于造影前48 h和造影后48 h口服NAC 600 mg,每日2次;B组患者于造影前48 h和造影后48 h口服NAC 600 mg,每日1次;C组患者于造影前48 h和造影后48 h口服安慰剂,每日1次。结果:本组共发生造影剂肾病(CAN)11例(14.9%),A组CAN发生率显著低于B组和C组(P<0.05);A组造影后48 h肾功能指标明显优于B组和C组(P<0.05);造影后28 h,5 d和7 d,A组24 h尿蛋白明显低于B组和C组(P<0.05)。结论:口服N-乙酰半胱氨酸600 mg,每日2次可有效预防碘海醇造影所致老年患者肾功能损害。
Objective: To investigate the clinical value of N-acetylcysteine (NAC) in the prevention of renal damage induced by iohexol in elderly patients. Methods: Seventy-four elderly patients with intravenous Iohexol-enhanced CT examination in our hospital from September 2011 to October 2012 were randomly divided into treatment group A (n = 26) Patients in group A received NAC 600 mg twice daily at 48 hours before angiography and 48 hours after angiography in group B (n = 25 in group B) and in control group (n = 23 in group C) NAC 600 mg was administered orally once a day for 48 hours before and 48 hours after angiography. Patients in group C were given placebo once a day at 48 hours before and 48 hours after angiography. Results: A total of 11 cases (14.9%) of contrast nephropathy (CAN) occurred in this group. The incidence of CAN in group A was significantly lower than that in group B and C (P <0.05) Group B and C (P <0.05). At 28, 5 and 7 days after angiography, 24-hour urinary protein in group A was significantly lower than those in group B and C (P <0.05). Conclusion: Oral administration of N-acetylcysteine 600 mg twice daily can effectively prevent the renal damage caused by iohexol in elderly patients.