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诺多甲基酸用于预防对比引起的脏病:一项随机对照试验
Gregg W Stone1, Peter A McCullough, James A Tumlin
1Department of Cardiology, Cardiovascular Research Foundation and Lenox Hill Heart and Vascular Institute, New York, NY 10022, USA. gstone@crf.org
在接受心脏手术的患有功能衰竭的患者中,芬诺多甲基酸并没有预防对比性病. 这项研究发现,芬诺多帕姆在预防脏损伤方面与安慰剂相比没有显著的益处.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 对比诱导性病 (CIN) 在接受侵入性心脏手术的患者中增加了心血管疾病和死亡率.
- 在之前的研究中,作为多巴胺-1受体激动剂的芬诺多甲基酸盐在保护脏血流和改善CIN方面表现出潜在的潜力.
研究的目的:
- 评估芬诺多甲基酸盐在接受侵袭性心血管手术的患者中预防对比性病的疗效.
主要方法:
- 一项前性,安慰剂控制,双盲,多中心随机试验,涉及315名功能受损患者 (肌素清除率<60毫升/分钟).
- 患者在血管造影前一小时开始接受静脉注射费诺多帕姆甲基酸盐或安慰剂,并持续12小时.
- 对比诱导的脏病被定义为血清肌素在术后96小时内增加≥25%,并进行30天的临床随访.
主要成果:
- 对比诱导的脏病发病率在芬诺多帕姆组为33.6%,而在安慰剂组为30.1% (相对风险1.11;95% CI,0.79-1.57;P =.61).
- 在30天死亡率,透析率或再住院率方面,研究小组之间没有发现显著差异.
- 患者平均年龄为70岁,49%患有糖尿病,平均基线肌素清除量为29毫升/分钟.
结论:
- 费诺多巴姆酸盐在接受侵入性心血管手术的慢性功能不全患者中预防对比诱导的病方面没有表现出有效性.
- 这项研究表明,芬诺多巴姆酸并不能防止这种患者群体的功能进一步恶化.
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