Divisione di Cardiologia, Dipartimento di Medicina, Chirurgia, Odontoiatria, Ospedale San Paolo, University of Milan, Via A. di Rudiní 8, Milan, Italy.
Clin Cardiol. 2010 Mar;33(3):E63-8. doi: 10.1002/clc.20576.
Contrast-induced nephropathy (CIN) is the third cause of acute deterioration of renal function in hospitalized patients.
The purpose of the study was to compare the efficacy of saline infusion, saline infusion plus N-acetylcysteine (NAC), and sodium bicarbonate (SB) infusion to prevent CIN in patients undergoing coronary angiography and/or percutaneous coronary intervention.
We prospectively studied 156 patients with a baseline creatinine level > or = 1.2 mg/dL. The primary endpoint was the development of CIN, defined as an increase in serum creatinine concentration > or = 25% over the baseline value within 5 days from contrast exposure.
Contrast-induced nephropathy developed in 23 patients (14.7%). Incidence of the primary endpoint was similar in the 3 groups of treatment, occurring in 7 patients (14%) in the saline infusion group, in 9 (17%) in the saline infusion plus NAC group, and in 7 (14%) in the SB infusion group.
Our findings suggest that neither the addition of NAC nor the administration of SB add further benefit in CIN prevention, compared to standard hydration with isotonic saline infusion.
对比剂肾病（CIN）是住院患者肾功能急性恶化的第三大原因。
本研究的目的是比较生理盐水输注、生理盐水输注加 N-乙酰半胱氨酸（NAC）和碳酸氢钠（SB）输注在预防接受冠状动脉造影和/或经皮冠状动脉介入治疗的患者 CIN 方面的疗效。
我们前瞻性研究了 156 例基线肌酐水平 >或=1.2mg/dL 的患者。主要终点是 CIN 的发生，定义为在造影剂暴露后 5 天内血清肌酐浓度比基线值升高 >或=25%。
23 例患者（14.7%）发生对比剂肾病。3 组治疗的主要终点发生率相似，生理盐水输注组 7 例（14%），生理盐水输注加 NAC 组 9 例（17%），SB 输注组 7 例（14%）。
与标准等渗盐水输注相比，NAC 的添加或 SB 的给药在 CIN 预防方面没有额外获益。
