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ω-3补充剂预防择期经皮冠状动脉介入治疗患者造影剂肾病:一项随机安慰剂对照试验

Omega-3 Supplementation in the Prevention of Contrast Induced Nephropathy in Patients Undergoing Elective Percutaneous Coronary Intervention: A Randomized Placebo-Controlled Trial.

作者信息

Foroughinia Farzaneh, Mirjalili Mahtabalsadat, Mirzaei Ehsan, Oboodi Alireza

机构信息

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Clinical Pharmacy Department, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Adv Pharm Bull. 2019 Jun;9(2):307-313. doi: 10.15171/apb.2019.036. Epub 2019 Jun 1.

Abstract

Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. Several studies have revealed the protective role of omega-3 in prevention and treatment of some kidney injuries. This study was conducted to examine the effect of omega-3 supplementation on the markers of renal function and to evaluate its potential in the prevention of CIN in patients undergoing elective percutaneous coronary intervention (PCI). In this double-blind, randomized clinical trial, 85 eligible patients scheduled for PCI was randomly divided into omega-3 (a single 3750 mg dose of omega-3 as well as routine hydration therapy within 12 hours before PCI) or control (placebo plus routine hydration therapy) groups. Serum creatinine (SCr) and cystatin C levels were measured at baseline and 24 hours after PCI. Our results indicated that post- PCI cystatin C levels were significantly decreased in the omega-3 group compared to the control group ( < 0.001). Although less upward manner was seen in the level of 24-hour creatinine in the omega-3 group, it did not reach the significance level ( = 0.008). The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of CIN in post-PCI patients with normal kidney function. However, to better assess this effect, it is highly recommended to design future studies with higher doses and longer duration of therapy with omega-3 plus long-term follow up.

摘要

造影剂肾病(CIN)是医院获得性肾衰竭的第三大原因,与显著的发病率和死亡率相关。多项研究揭示了ω-3在预防和治疗某些肾脏损伤中的保护作用。本研究旨在探讨补充ω-3对肾功能标志物的影响,并评估其在接受择期经皮冠状动脉介入治疗(PCI)患者中预防CIN的潜力。在这项双盲、随机临床试验中,85例计划接受PCI的合格患者被随机分为ω-3组(PCI前12小时单次服用3750mgω-3以及常规水化治疗)或对照组(安慰剂加常规水化治疗)。在基线和PCI后24小时测量血清肌酐(SCr)和胱抑素C水平。我们的结果表明,与对照组相比,ω-3组PCI后胱抑素C水平显著降低(<0.001)。虽然ω-3组24小时肌酐水平升高幅度较小,但未达到显著水平(=0.008)。ω-3对胱抑素C水平的积极作用表明,它可能对肾功能正常的PCI后患者预防CIN具有保护作用。然而,为了更好地评估这种效果,强烈建议设计未来的研究,采用更高剂量、更长疗程的ω-3治疗并进行长期随访。

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