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目的:探讨还原型谷胱甘肽对糖尿病患者冠状动脉造影术后对比剂肾病(CIN)的预防作用.方法:选取我院2015-01-2016-06收治的糖尿病且拟行冠状动脉造影术和(或)经皮冠状动脉介入术(PCI)的患者90例,采用前瞻性临床对照研究的方法随机分组为治疗组(44例)和对照组(46例).治疗组给予还原型谷胱甘肽联合水化治疗,对照组仅给予水化治疗,比较2组术前及术后72 h肾功能指标(血肌酐、血胱抑素C、肾小球滤过率)及CIN的发病率.结果:①术后72 h,治疗组患者血肌酐和血胱抑素水平显著低于对照组[(89.5±18.4)μmol/L∶(99.5±20.4)μmol/L,P=0.016;(0.93±0.25)mg/L∶(1.18±0.33)mg/L,P=0.000 1],而肾小球滤过率则显著高于对照组[(92.5±22.5)ml· min-1·1.73 m-2∶(82.7±23.5)ml· min-1· 1.73 m-2,P=0.045];②本研究中共9例患者诊断为CIN,总体发病率为10％.其中治疗组和对照组CIN的发病率分别为2.33％和17.39％,差异有统计学意义(x2=4.155,P=0.042).结论:糖尿病患者行PCI诊疗后有较高的CIN发生风险,而应用还原型谷胱甘肽联合水化疗法可一定程度上降低糖尿病患者发生CIN的风险.“,”Objective:To explore the preventive effect of reduced glutathione on contrast-induced nephropathy (CIN) in patients with diabetes undergoing coronary angiography.Method:Ninety patients with diabetes who were admitted in our hospital from January,2015 to June,2016 and scheduled for coronary angiography or percutaneous coronary intervention (PCI) were randomly divided into treatment group (n=44) and control group (n=46).Patients in treatment group received reduced glutathione and hydration therapy,and those in control group only received hydration therapy.Change of renal function indexes (serum creatinine,cystatin-C and glomerular filtration rate) before and after angiography and the incidence rate of contrast nephropathy were compared.Result:①Seventy-two hours after the surgery,the levels of serum creatinine and cystatin-c in treatment group were both significantly lower than those in control group [(89.5 ± 18.4) μmol/L vs.(99.5 ± 20.4) μmol/L,P =0.016；(0.93 ± 0.25)mg/L vs.(1.18±0.33)mg/L,P=0.000 1],while the level of glomerular filtration rate in treatment group was significantly higher than that in control group [(92.5±22.5)ml · min-1 · 1.73 m-2 vs.(82.7±23.5)ml · min-1 · 1.73 m-2,P=0.045].②9 patients were diagnosed with CIN and the overall occurrence was 10.00％.The incidence rate of CIN in treatment group and control group was 2.33％ and 17.39％ (x2 =4.155,P=0.042).Conclusion:There was high risk for CIN in patients with diabetes undergoing coronary angiography or PCI,preoperative application of reduced glutathione and hydration can reduce the risk of CIN in these patients to some extent.