曲美他嗪对肾功能不全患者对比剂肾病的预防作用

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摘要目的：探讨肾功能不全患者应用曲美他嗪（TMZ）预防对比剂肾病（CIN）的临床疗效。方法：本研究为前瞻性随机对照临床试验，连续入选124例拟行冠状动脉造影或冠状动脉介入术患者，基础血清肌酐（Scr）＞103μoml/L，随机分为2组：TMZ组（n=64）和对照组（n=60）。TMZ组于造影前48 h给予TMZ片20 mg，每天3次，术后服用7 d。所有患者均于术前及术后接受常规水化治疗，观察患者术前、术后24 h、48 h、7 d的Scr水平。结果：①2组患者术后24 h Scr水平差异无统计学意义（P＞0.05）；②TMZ组术后48 h、7 d
的Scr水平明显低于对照组（P＜0.05）；③TMZ组CIN的发生率为3.1%，对照组为16.7%，2组比较差异有统计学意义（P＜0.05）。结论：TMZ联合水化治疗与单独水化治疗相比，能减少肾功能不全患者CIN的发生率。

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关键词 ：曲美他嗪, 对比剂肾病, 预防

Abstract：Objective: To evaluate the efficacy of trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN) in patients with renal insufficiency. Methods: We conducted a prospective, randomized, controlled trial, 124 patients undergoing coronary angiography/angioplasty were involved, whose stable serum creatinine levels were at least 103 μoml/L. They were divided into TMZ group (n=64) and control group (n=60) randomly, TMZ group received TMZ (20 mg thrice daily) orally for 7 d starting 48 h before the procedure. All patients were given routine hydration treatment before and after the procedure. Serum creatinine (Scr) levels were measured before the procedure, 24 h, 48 h and 7 d after the procedure. Results: ①Scr levels had no statistical significance in the two groups 24 h after the procedure (P>0.05). ②Scr levels significantly decreased after 48 h and 7 d in the TMZ group (P<0.05). ③CIN developed in 3.1% of patients in the TMZ group and in 16.7% of patients in the control group (P<0.05). Conclusion: TMZ along with isotonic saline hydration is more effective than isotonic saline alone in reducing the risk of CIN in patients with renal insufficiency

Key words： trimetazidine contrast-induced nephropathy prevention

收稿日期: 2013-07-22

作者简介: 陈严（1982-），女，浙江桐乡人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2014/V44/I9/675

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