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一项针对他汀类药物对造影剂肾病预防作用的随机试验的网状荟萃分析。

A network meta-analysis on randomized trials focusing on the preventive effect of statins on contrast-induced nephropathy.

作者信息

Peruzzi Mariangela, De Luca Leonardo, Thomsen Henrik S, Romagnoli Enrico, D'Ascenzo Fabrizio, Mancone Massimo, Sardella Gennaro, Lucisano Luigi, Abbate Antonio, Frati Giacomo, Biondi-Zoccai Giuseppe

机构信息

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy.

Department of Cardiovascular Sciences, European Hospital, 00149 Rome, Italy.

出版信息

Biomed Res Int. 2014;2014:213239. doi: 10.1155/2014/213239. Epub 2014 Sep 7.

Abstract

Contrast-induced nephropathy is a common complication of iodinated contrast administration. Statins may reduce the risk of contrast-induced nephropathy, but data remain inconclusive. We summarized the evidence based on statins for the prevention of contrast-induced nephropathy with a network meta-analysis. Randomized trials focusing on statins were searched and pooled with random-effect odds ratios. A total of 14 trials (6,160 patients) were included, focusing on atorvastatin (high/low dose), rosuvastatin (high dose), simvastatin (high/low dose), and placebo or no statin therapy before contrast administration. The risk of contrast-induced nephropathy was reduced by atorvastatin high dose and rosuvastatin high dose, with no difference between these two agents. Results for atorvastatin low dose and simvastatin (high/low dose) in comparison to placebo were inconclusive. Atorvastatin and rosuvastatin administered at high doses and before iodinated contrast administration have a consistent and beneficial preventive effect on contrast-induced nephropathy and may actually halve its incidence.

摘要

对比剂肾病是使用碘化对比剂时常见的并发症。他汀类药物可能会降低对比剂肾病的风险,但相关数据仍无定论。我们通过网状Meta分析总结了基于他汀类药物预防对比剂肾病的证据。检索了聚焦于他汀类药物的随机试验,并采用随机效应比值比进行汇总。共纳入14项试验(6160例患者),重点关注阿托伐他汀(高/低剂量)、瑞舒伐他汀(高剂量)、辛伐他汀(高/低剂量),以及对比剂给药前使用安慰剂或不使用他汀类药物治疗的情况。高剂量阿托伐他汀和高剂量瑞舒伐他汀可降低对比剂肾病的风险,这两种药物之间无差异。低剂量阿托伐他汀和辛伐他汀(高/低剂量)与安慰剂相比的结果尚无定论。高剂量阿托伐他汀和瑞舒伐他汀在碘化对比剂给药前使用,对对比剂肾病具有一致且有益的预防作用,实际上可能会使其发生率减半。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dc2/4170696/4a1d8a5850b8/BMRI2014-213239.001.jpg

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