用二碳酸预防对比引起的脏病:一项随机对照试验
Gregory J Merten1, W Patrick Burgess, Lee V Gray
1Department of Internal Medicine, Sanger Cardiology, Sanger Cardiovascular Surgery, and Metrolina Nephrology, Carolinas Medical Center, Charlotte, NC 28232, USA.
JAMA
|May 20, 2004
概括
与化相比,二碳酸水化显著降低了对比引起的脏病的风险. 这项研究表明,二碳酸是二碳酸.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是指放射学
- 药理学 药理学是指药理学的学科.
背景情况:
- 对比诱导性脏病 (CIN) 是放射性手术后的常见并发症.
- 动物研究表明,二碳酸比化对急性缺血性功能衰竭更有保护作用.
- 自由基损伤是缺血和对比引起的急性功能衰竭的建议机制,但缺乏关于二碳酸预防功效的临床数据.
研究的目的:
- 为了评估二碳酸与化在放射性对比剂施用前后预防性水分的有效性.
- 为了比较接受二碳酸和化水化治疗的患者之间对比诱导的脏病的发生率.
主要方法:
- 一个前性,单中心随机试验,涉及119名患有先前存在的功能缺陷 (血清肌素≥1.1 mg/dL) 的患者.
- 患者被随机分配,在对比介质 (iopamidol) 之前和之后接受化或二碳酸 (154 mEq/L) 的静脉注射水分.
- 在基线和对比后两天监测血清肌素水平,以确定对比诱导的脏病 (血清肌素≥25%的增加).
主要成果:
- 与化组 (13.6%) (P = .02) 相比,在二碳酸组 (1.7%) 中,对比诱导脏病的发生率明显较低.
- 两组之间在基线特征 (包括年龄,性别,糖尿病,种族或对比度量) 上没有发现显著差异.
- 随后对191名接受预防性二碳酸治疗的患者进行的注册显示,CIN的发病率同样低 (1.6%).
结论:
- 在对比暴露之前用二碳酸静脉注射水分是一种比化更有效的策略,用于预防对比诱导的功能衰竭.
- 碳酸水化证明了在接受放射性手术的患者中对CIN具有显著的保护作用.
- 这些发现支持使用二碳酸作为CIN的预防剂.
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