Li Guangping, Yin Li, Liu Tong, Zheng Xintian, Xu Gang, Xu Yanmin, Yuan Ruyu, Che Jingjin, Liu Hongmei, Zhou Lijuan, Chen Xin, He Mei, Li Yiding, Wu Lei, Liu Enzhao
Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, People's Republic of China.
Am J Cardiol. 2009 Feb 15;103(4):512-4. doi: 10.1016/j.amjcard.2008.10.009. Epub 2008 Dec 25.
Enhanced production and reduced removal of oxygen free radicals may play an important role in the pathogenesis of the contrast-induced acute kidney injury (CIAKI). Probucol, a lipid-lowering drug with potent antioxidant properties, has been widely used clinically for the prevention of the progression of atherosclerosis. We performed a prospective, randomized controlled trial to investigate the role of probucol in the prevention of CIAKI in patients undergoing planned coronary angiography (CAG) or intervention. The 205 patients who underwent planned CAG or intervention were randomly assigned to either the probucol group (n = 102; 500 mg orally twice daily) or the control group (n = 103). Renal function was assessed at the time of hospital admission and on days 1, 2, and 3 after the procedure. CIAKI occurred in 23 (11.22%) of the 205 patients. The incidence of CIAKI in the probucol group was slightly lower compared with the control group (7.84% vs 14.56%) but without significant difference (p = 0.13). The postprocedure mean peak of serum creatinine (1.15 +/- 0.49 vs 1.33 +/- 0.78 mg/dl, p = 0.04) and the postprocedure increasing Scr from baseline (0.15 +/- 0.22 vs 0.25 +/- 0.21 mg/dl, p = 0.001) in the probucol group were significantly lower than those in the control group. In conclusion, prophylactic treatment with probucol during the periprocedural stage in patients undergoing coronary angiography or intervention has a preventive role against CIAKI.
氧自由基生成增加和清除减少可能在造影剂诱导的急性肾损伤(CIAKI)发病机制中起重要作用。普罗布考是一种具有强大抗氧化特性的降脂药物,已在临床上广泛用于预防动脉粥样硬化进展。我们进行了一项前瞻性随机对照试验,以研究普罗布考在接受择期冠状动脉造影(CAG)或介入治疗的患者中预防CIAKI的作用。205例接受择期CAG或介入治疗的患者被随机分为普罗布考组(n = 102;每日口服两次,每次500 mg)或对照组(n = 103)。在入院时以及术后第1、2和3天评估肾功能。205例患者中有23例(11.22%)发生CIAKI。普罗布考组CIAKI的发生率略低于对照组(7.84%对14.56%),但无显著差异(p = 0.13)。普罗布考组术后血清肌酐的平均峰值(1.15±0.49对1.33±0.78 mg/dl,p = 0.04)以及术后血清肌酐相对于基线的升高幅度(0.15±0.22对0.25±0.21 mg/dl,p = 0.001)均显著低于对照组。总之,在接受冠状动脉造影或介入治疗的患者围手术期阶段,使用普罗布考进行预防性治疗对CIAKI具有预防作用。