Zhao Kai, Lin Yu, Li Yong-Jian, Gao Sheng
Department of Cardiology, Tianjin Nankai Hospital Tianjin 300100, China.
Int J Clin Exp Med. 2014 Dec 15;7(12):5758-64. eCollection 2014.
Contrast-induced nephropathy (CIN) is one of the major causes of hospital-acquired acute renal failure. The pathophysiological mechanism of CIN remains unknown. There has been little evidence regarding the effects of Traditional Chinese Medicine (TCM) on CIN. Cordyceps sinensis (CS), a traditional Chinese herb, has been widely used clinically for the prevention of the progression of renal failure. We performed a prospective, randomized controlled trial to investigate the role of CS in the prevention of CIN in patients with acute coronary syndrome (ACS) undergoing elective percutaneous coronary intervention (PCI). The 150 ACS patients were randomly assigned to three groups, basic treatment group (n=51), standard CS therapy group (n=49, corbrin capsule 2 g, 3 times/d were used 3 days before and after angiography), and intensive CS therapy group (n=50, corbrin capsule 3 g, 3 times/d were used 3 days before and after angiography). Renal function was assessed at the time of hospital admission and on days 1, 2, and 3 after PCI. CIN occurred in 13 of 150 patients (8.67%). The incidence of CIN was lower in the CS treatment groups than in the basic treatment group (P<0.05), and a significant decrease in the incidence of CIN in the intensive CS therapy group was shown (P<0.01). In conclusion, prophylactic treatment with CS during the peri-procedural stage in ACS patients undergoing elective PCI has a preventive role against CIN, and intensive CS therapy could be more effective.
对比剂肾病(CIN)是医院获得性急性肾衰竭的主要原因之一。CIN的病理生理机制尚不清楚。关于中药对CIN影响的证据很少。冬虫夏草(CS),一种传统中药,已在临床上广泛用于预防肾衰竭的进展。我们进行了一项前瞻性随机对照试验,以研究CS在接受择期经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者中预防CIN的作用。150例ACS患者被随机分为三组,基础治疗组(n = 51)、标准CS治疗组(n = 49,造影前3天及造影后3天每天3次服用2g百令胶囊)和强化CS治疗组(n = 50,造影前3天及造影后3天每天3次服用3g百令胶囊)。在入院时以及PCI术后第1、2和3天评估肾功能。150例患者中有13例(8.67%)发生CIN。CS治疗组CIN的发生率低于基础治疗组(P<0.05),强化CS治疗组CIN的发生率显著降低(P<0.01)。总之,在接受择期PCI的ACS患者围手术期用CS进行预防性治疗对CIN有预防作用,强化CS治疗可能更有效。