伊洛普罗斯特可以预防患有功能障碍,正在接受冠状动脉血管学或干预的患者的对比诱导性病
Konstantinos Spargias1, Elias Adreanides, Eftihia Demerouti
1Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece. spargias@ocsc.gr
Circulation
|October 21, 2009
概括
在接受冠状动脉手术的高风险患者中,伊洛普罗斯特显著降低了对比诱导的病. 这种前环素模拟剂提供了一种潜在的保护策略,可以防止对比剂对损伤.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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) 是致病率和死亡率的重要原因之一.
- 脏血管收缩是CIN发展的关键因素.
- 迫切需要有效的CIN预防策略,特别是在功能障碍患者中.
研究的目的:
- 评估前环素类似物伊洛普罗斯特在预防CIN方面的疗效.
- 评估伊洛普罗斯特在接受冠状动脉手术的先前存在功能障碍的患者的保护作用.
主要方法:
- 进行了一项随机,双盲,安慰剂控制的试验.
- 纳入了208名血清肌素≥1.4mg/dL的患者,这些患者正在接受冠状动脉血管造影/干预.
- 在手术前和之后,静脉注射伊洛普罗斯特 (1 ng/kg/min) 或安慰剂.
主要成果:
- 在安慰剂组中,CIN发生率为22%,而在伊洛普罗斯特组中为8% (OR,0.29;P=0.005).
- 在对照组中,估计的淋巴细胞过率 (eGFR) 降低了,但在伊洛普罗斯特组中显示出小幅增加.
- 与安慰剂相比,伊洛普罗斯特的使用与eGFR的明显较小的下降有关.
结论:
- 伊洛普罗斯特的预防性使用显示出对CIN的潜在保护作用.
- 伊洛普罗斯特可能是接受冠状动脉手术的高风险患者的宝贵治疗选择.
- 进一步的研究可能会证实伊洛普罗斯特在CIN预防中的作用.
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