Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
Chin Med J (Engl). 2012 Oct;125(19):3368-72.
Anisodamine is widely used in therapy for treating acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation. We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.
A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate (eGFR) of 60 ml(-1)×min(-1)×1.73 m(-2) or less, who were undergoing coronary angiography or angioplasty, were randomly assigned to receive an infusion of either sodium chloride (control group, n = 128) or anisodamine (treatment group, n = 132). Patients in the treatment group received an infusion of anisodamine at a rate of 0.2 µg×kg(-1)×min(-1) from 12 hours before to 12 hours after coronary angiography or angioplasty, while patients in the control group received an infusion of sodium chloride with the same volume as the treatment group. All patients received intravenous sodium chloride hydration. CIN was defined as a 25% increase in serum creatinine from baseline or an absolute increase of > 0.5 mg/dl within three days after contrast exposure. The primary end point was the incidence of CIN. The secondary end point was a 25% or greater reduction in eGFR.
There were no significant differences between the two groups with regard to age, gender, risk factors, laboratory results, medications and interventions. The incidence of CIN was 9.8% (13/132) in the treatment group and 20.3% (26/128) in the control group (P < 0.05). The secondary end point was 6.0% (8/132) in the treatment group and 16.4% (21/128) in the control group (P < 0.05).
These results indicate the preventive effects of anisodamine against CIN in type 2 diabetics with renal insufficiency who are undergoing coronary angiography or angioplasty.
山莨菪碱由于能改善肾微循环，故广泛用于治疗急性肾小球肾炎和糖尿病肾病。我们进行了一项研究，旨在评估山莨菪碱对接受冠状动脉造影或血管成形术的肾功能不全 2 型糖尿病患者对比剂肾病（CIN）的预防作用。
共有 260 例估计肾小球滤过率（eGFR）为 60ml(-1)×min(-1)×1.73m(-2)或更低的 2 型糖尿病患者，他们正在接受冠状动脉造影或血管成形术，被随机分配接受氯化钠（对照组，n=128）或山莨菪碱（治疗组，n=132）输注。治疗组患者从冠状动脉造影或血管成形术前 12 小时至术后 12 小时以 0.2μg×kg(-1)×min(-1)的速度输注山莨菪碱，而对照组患者以与治疗组相同体积输注氯化钠。所有患者均接受静脉氯化钠水化。CIN 的定义为造影后 3 天内血清肌酐较基线升高 25%或绝对值升高>0.5mg/dl。主要终点是 CIN 的发生率。次要终点是 eGFR 下降 25%或更多。
两组在年龄、性别、危险因素、实验室结果、药物和干预措施方面无显著差异。治疗组 CIN 的发生率为 9.8%（13/132），对照组为 20.3%（26/128）（P<0.05）。次要终点是治疗组为 6.0%（8/132），对照组为 16.4%（21/128）（P<0.05）。
这些结果表明山莨菪碱对接受冠状动脉造影或血管成形术的肾功能不全 2 型糖尿病患者 CIN 的预防作用。
