CAJ | 학술논문

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。
목적：탐토곡미타진예방신공능불전환자조영제신병적료효。방법：장2010년4월－2014년3월아과수치적의행관맥조영적신공능불전환자100례수궤분위연구조화대조조각50례，연구조행수화치료＋곡미타진구복치료，대조조부접수수화치료，비교량조술전、술후1 d、3 d、7 d 혈기항（Scr）、초양화물기화매（SOD）적변화급발생조영제신병적례수。결과：연구조술전여술후비교，Scr 수평정정체하강추세，술후7 d 적Scr 수평현저저우술전；대조조술전여술후3 d 비교，Scr 수평현저승고，술후7 d 적 Scr 수평유소회락，단잉고우술전수평。연구조술후SOD 수평정정체상승추세，차술후3 d、7 d 적SOD 수평균현저고우술전；대조조적SOD 수평재술전술후적변화무통계학차이。연구조조영제신병적발생례수명현저우대조조（4 VS 9，P＜0．05）。결론：신공능불전환자행관맥조영시，동시급여수화치료급구복곡미타진교단순수화치료경능예방조영제신병。
Objective:To explore the effect of Trimetazidine preventing contrast media-induced nephropathy in patients with renal insufficiency. Method:100 renal insufficiency patients who were going to do coronary angiography were randomly divided into research group (n=50) and control group (n=50) from Apr 2012 to March 2014. The research group was received hydration therapy and trimetazidine oral therapy , while the control group was received only hydration treatment. Before coronary angiography,1 day,3 days,7 days after coronary angiography,serum creatinine (Scr), superoxide dismutase (SOD) and the number of contrast-induced nephropathy were compared between the two groups. Results:Scr level decreased after coronary angiography in research group , while which increased in 3 days and 7 days after coronary angiography and then decreased in the control group. SOD level increased after coronary angiography in research group. Yet it remained the same in the control group both 3 days and 7 days after coronary angiography. The contrast media-induced nephropathy cases happened in research group was significantly lower than that in the control group ( 4 VS 9,P<0.05). Conclusion: Comparing with the only hydration treatment,combined with Trimetazidine can prevents contrast media-induced nephropathy effectively in patients with renal insufficiency going to do coronary angiography.