复合Danshen滴液药在皮肤穿透冠状动脉干预后对比引起的脏病的预防作用和机制
Han Fu1,2, Linrui Wang3, Shuo Ying4
1Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Frontiers in cardiovascular medicine
|December 21, 2023
概括
化合物丹申滴滴药 (CDDP) 在进行冠状动脉支架植入的患者中显著降低了对比诱导脏病 (CIN) 的发生率. 这项研究突出了CDDP的重点.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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) 是冠状动脉支架植入后的常见并发症.
- 化合物丹申滴液药 (CDDP) 用于心血管疾病,可以减轻CIN.
- 之前关于CDDP在支架后预防CIN的有效性的证据是不确定的.
研究的目的:
- 预期评估复合丹申滴液药 (CDDP) 预防皮肤穿透冠状动脉干预 (PCI) 患者的对比诱导脏病 (CIN) 的疗效.
- 评估CDDP对PCI后的功能标志物,炎症和氧化应激的影响.
- 确定患有CIN风险较高的患者子组.
主要方法:
- 一项前性,随机化,单中心,单盲,受控试验,涉及822名患有不稳定性胸痛或NSTEMI的患者接受PCI.
- 患者接受了CDDP加补水疗法 (n=411) 或单独补水疗法 (n=411) 30天.
- 主要终点是CIN发病率,定义为对比剂暴露后48-72小时内血清肌素升高.
主要成果:
- 与仅补水组相比,CDDP组在手术后48小时和72小时表现出明显较低的血清肌素和血尿素水平.
- 在之前接受CDDP治疗的患者中,CIN发生率显著降低.
- 增加的CIN风险与左心室喷射率<50%,对比度体积≥160ml和高血压有关. 各组之间观察到NGAL,TNF-α,SOD和MDA水平的显著差异,但在Bax,Bcl-2或Casepase-9中没有.
结论:
- 在冠状动脉支架植入后,使用复合丹申滴液药 (CDDP) 的预治疗有效预防对比诱导脏病 (CIN).
- CDDP的保护机制可能涉及炎症反应和氧化应激的调节.
- 对于CIN的风险分层应考虑LVEF,对比度体积和高血压等因素.
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