预防对比介质诱导病的缺血预条件:随机试点RenPro试验 (脏保护试验)
Fikret Er1, Amir M Nia, Henning Dopp
1Department of Internal Medicine III, University of Cologne, Germany. Fikret.Er@uk-koeln.de
Circulation
|June 28, 2012
概括
远程缺血预调显著降低了在接受冠状动脉动脉扫描的高风险患者中,对比剂引起的急性损伤的风险. 这种非侵入性方法提供了一个有前途的保护策略,防止脏损伤.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 相反,中等诱导的急性损伤 (CM-AKI) 是一种与相当大的发病率和死亡率相关的严重并发症.
- 缺血性损伤是参与CM-AKI发展的关键机制.
- 需要有效的策略来预防CM-AKI,特别是在高风险患者群体中.
研究的目的:
- 评估远程缺血预制 (RIPC) 在预防CM-AKI方面的有效性.
- 评估RIPC在选择性冠状动脉血管学期间对比剂暴露后对功能的影响.
主要方法:
- 进行了一项随机的,双盲的,假的受控试验.
- 接受冠状动脉动图的功能受损的高风险患者被随机分配到接受标准护理或RIPC (间歇性臂缺血).
- CM-AKI被定义为在手术后48小时内血清肌素水平显著增加.
主要成果:
- 与对照组 (40%) 相比,在RIPC组中,CM-AKI的发病率明显较低 (12%).
- RIPC显示出显著的保护作用,赔率比为0.21 (95% CI,0.07-0.57;P=0.002).
- 没有任何重大不良事件被归因于RIPC程序.
结论:
- 远程缺血预调是一种有效的策略,用于预防高风险患者的对比介质诱导的急性损伤.
- 这些发现支持需要进行更大规模的临床试验,以确认RIPC对患者结果的影响.
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