Zhou Shiju, Wu Chaoran, Song Qingyin, Yang Xu, Wei Zixiu
Department of Nephrology, Jining No. 1 People's Hospital, Jining, China.
Nephron. 2016;133(1):1-14. doi: 10.1159/000445167. Epub 2016 May 21.
The purpose of this study was to evaluate the effect of angiotensin-converting enzyme inhibitors (ACEIs) on contrast-induced nephropathy (CIN) in patients undergoing coronary angiography or percutaneous coronary intervention (PCI).
We searched the Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP database and Wanfang database up to December 2014. Pooled risk ratios (RRs) or weighted mean difference (WMD) with their 95% CIs for the CIN incidence, serum creatinine (SCr), estimated glomerular filtration rate (eGFR) and blood urea nitrogen (BUN) of the patients were collected and calculated using the software Review Manager 5.2.
A total of 12 separate studies including 1,868 patients (1,011 ACEI cases and 857 controls) were considered in the meta-analysis. The overall RR of the incident CIN in the ACEI group vs. the control group was 0.95 (95% CI 0.57-1.58), and the total WMDs of the x0394;SCr, x0394;eGFR and x0394;BUN were -0.01 (95% CI -0.04 to 0.02), 5.71 (95% CI -0.66 to 12.09) and 0.78 (95% CI -0.16 to 1.73), respectively. Besides, the RR of CIN incidence in the captopril group vs. the control group was 0.72 (95% CI 0.25-2.05, p = 0.54), and the pooled WMD of the x0394;SCr was -0.13 (95% CI -0.21 to -0.06, p < 0.01).
This meta-analysis suggests that ACEIs administration has no significant influence in the CIN of patients undergoing coronary angiography or PCI; however, captopril might have the potential to prevent CIN.
本研究旨在评估血管紧张素转换酶抑制剂（ACEI）对接受冠状动脉造影或经皮冠状动脉介入治疗（PCI）患者造影剂肾病（CIN）的影响。
检索截至2014年12月的Medline、Embase、Cochrane图书馆、中国知网、重庆维普数据库和万方数据库。使用Review Manager 5.2软件收集并计算患者CIN发生率（合并风险比[RRs]）或加权均数差（WMD）及其95%可信区间（CIs），以及血清肌酐（SCr）、估计肾小球滤过率（eGFR）和血尿素氮（BUN）。
荟萃分析共纳入12项独立研究，包括1868例患者（1011例ACEI组病例和857例对照组）。ACEI组与对照组相比，CIN发生的总体RR为0.95（95%CI 0.57 - 1.58），ΔSCr、ΔeGFR和ΔBUN的总WMD分别为 -0.01（95%CI -0.04至0.02）、5.71（95%CI -0.66至12.09）和0.78（95%CI -0.16至1.73）。此外，卡托普利组与对照组相比，CIN发生率的RR为0.72（95%CI 0.25 - 2.05，p = 0.54），ΔSCr的合并WMD为 -0.13（95%CI -0.
