Abstract: Abstract   Objective   To investigate the preventive effect of N?acetylcysteine(NAC) on contrast induced nephropathy（CIN） in patients undergoing elective percutaneous coronary intervention（PCI）.Methods   five hundreds and twenty one patients who are about to undergo PCI in Tianjin Chest Hospital are randomly divided into either conventional treatment group（n=261） or NAC treatment group（n=260）. NAC treatment group are received oral NAC (600mg twice daily) for 48h preoperative and 72h postoperative PCI plug hydration, and the conventional treatment group are received only hydration. The levels of blood serum creatinine（Scr）,urea nitrogen（BUN）, creatinine clearance rate （Ccr）, C-reactive protein（CRP）, β2-microglobulin（β2-MG）, tumor necrosis factor-α（TNF-α）, interleukin-6（IL-6）, Superoxidedismutase（SOD）,Glutathione reductase（GSH） were measured at admission and 72h after the procedure. Result   （1）In the NAC treatment group, 16 patients present with CIN，the incidence of CIN was 6.2%;In the conventional treatment group, CIN occur in 10 patients, the incidence of CIN was 3.8%（χ2=1.48，p>0.05）.（2）There was no statistically difference in the levels of Scr,BUN,CRP、β2-MG,TNF-α,IL-6 ,SOD,GSH at admission（P>0.05）. 72h after the procedure, the levels of CRP、SOD、GSH were lower in NAC treatment group than the conventional treatment group, and the levels of CRP,SOD,GSH were higher than preoperative. Conclusion   Oxidative stress and inflammation may play a important role in the pathogenesis of CIN, N?acetylcysteine may not be beneficial in the prevention of CIN.

Key words: acetyl-cysteine, kidney diseases, Contrast agent, iopamidol, angioplasty, transluminal, percutaneous coronary, 对比剂肾病