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创新药物与仿制药引起的冠状动脉造影术相关肾功能不全的对比研究(对比研究)

Contrast between innovator drug- and generic drug-induced renal dysfunction on coronary angiography (CONTRAST study).

作者信息

Nakamura Ayumi, Miura Shin-Ichiro, Sugihara Makoto, Miyase Yuiko, Norimatsu Kenji, Shiga Yuhei, Nishikawa Hiroaki, Saku Keijiro

机构信息

Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.

出版信息

Heart Vessels. 2014 Sep;29(5):603-10. doi: 10.1007/s00380-013-0410-6. Epub 2013 Sep 27.

Abstract

Contrast-induced nephropathy (CIN) has gained increasing attention in clinical practice, particularly during coronary angiography (CAG). However, some "bioequivalent" generic (GE) drugs are less effective than the innovator (IN) drug. Therefore, the aim of this study was to compare contrast media (IN drug)-induced renal dysfunction with contrast media (GE drug)-induced dysfunction. We enrolled 44 patients who underwent elective CAG or percutaneous coronary intervention (PCI) and randomly divided them into two groups that received contrast media (Iohexol, nonionic and low-osmolality contrast agent) containing either IN drug (Omnipaque) or GE drug (Iopaque). Blood and urine sampling were performed before and after (24 and 48 h) CAG or PCI. Biochemical parameters in blood (serum creatinine, cystatin C, high-sensitivity C-reactive protein, and pentraxin-3) and urine (urinary albumin/Cr and liver-type fatty acid binding protein/Cr) were measured. There were no significant differences in the biochemical parameters at baseline between the groups. In addition, there were no differences in changes in biochemical parameters in blood and urine before and after CAG or PCI between the groups, although one patient in the GE group had CIN. The degree of contrast in Iopaque-induced renal dysfunction was comparable with that in Omnipaque-induced dysfunction.

摘要

对比剂肾病(CIN)在临床实践中越来越受到关注,尤其是在冠状动脉造影(CAG)期间。然而,一些“生物等效性”仿制药(GE)的效果不如创新药(IN)。因此,本研究的目的是比较造影剂(IN药物)诱导的肾功能障碍与造影剂(GE药物)诱导的功能障碍。我们纳入了44例接受择期CAG或经皮冠状动脉介入治疗(PCI)的患者,并将他们随机分为两组,分别接受含有IN药物(欧乃派克)或GE药物(碘帕醇)的造影剂(碘海醇,非离子型低渗造影剂)。在CAG或PCI前后(24小时和48小时)进行血液和尿液采样。测量血液(血清肌酐、胱抑素C、高敏C反应蛋白和五聚素-3)和尿液(尿白蛋白/肌酐和肝型脂肪酸结合蛋白/肌酐)中的生化参数。两组在基线时的生化参数无显著差异。此外,两组在CAG或PCI前后血液和尿液生化参数的变化也无差异,尽管GE组有1例患者发生了CIN。碘帕醇诱导的肾功能障碍的对比程度与欧乃派克诱导的功能障碍相当。

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