羟苯磺酸钙预防糖尿病合并慢性肾脏病患者造影剂肾病的效果。
Effect of Calcium Dobesilate in Preventing Contrast-Induced Nephropathy in Patients with Diabetes and Chronic Kidney Disease.
机构信息
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Information Department, the Second Hospital of Tianjin Medical University, Tianjin 300211, China.
出版信息
Clinics (Sao Paulo). 2021 Oct 18;76:e2942. doi: 10.6061/clinics/2021/e2942. eCollection 2021.
OBJECTIVES
This study assessed the protective effect of calcium dobesilate against contrast-induced nephropathy (CIN) after coronary angiography (CAG) or percutaneous coronary intervention (PCI) in patients with diabetes and chronic kidney disease (CKD).
METHODS
A total of 130 patients with diabetes and CKD estimated glomerular filtration rate: 30-90 mL/min/1.73m2 were enrolled and included in the analysis. They were divided into experimental (n=65) and control groups (n=65). Patients in the experimental group were administered oral calcium dobesilate (500 mg) three times daily for 2 days before and 3 days after the procedure. The serum creatinine (SCr), cystatin C (Cys C), and neutrophil gelatinase-associated lipocalin (NGAL) levels were measured before and after the procedure.
RESULTS
The mean SCr level at 24h after the procedure was found to be significantly lower in the experimental group than in the control group (79.1±19.6 μmol/L vs. 87.0±19.3 μmol/L, p=0.023). However, the Cys C and NGAL levels were not significantly different between the two groups at all measurement time points (all p>0.05). The incidence of CIN defined by the SCr level was significantly lower in the experimental group than in the control group (3 [4.6%] vs. 13 [20.0%], p=0.017). However, the incidence of CIN defined by the Cys C level was not statistically different between the two groups (7 [10.8%] vs. 7 [10.8%], p=1.000).
CONCLUSIONS
This study revealed that calcium dobesilate has no preventive effect against CIN in patients with diabetes and CKD.
目的
本研究评估了在患有糖尿病和慢性肾脏病（CKD）的患者中，在冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）前后应用羟苯磺酸钙对造影剂诱导的肾病（CIN）的保护作用。
方法
共纳入并分析了 130 例估算肾小球滤过率（eGFR）为 30-90 mL/min/1.73m2的糖尿病和 CKD 患者。他们被分为实验组（n=65）和对照组（n=65）。实验组患者在术前 2 天和术后 3 天每天口服羟苯磺酸钙（500mg）3 次。在术前和术后分别测量血清肌酐（SCr）、胱抑素 C（Cys C）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平。
结果
术后 24 小时，实验组的平均 SCr 水平明显低于对照组（79.1±19.6μmol/L vs. 87.0±19.3μmol/L，p=0.023）。然而，在所有测量时间点，两组的 Cys C 和 NGAL 水平均无显著差异（均 p>0.05）。根据 SCr 水平定义的 CIN 发生率实验组明显低于对照组（3[4.6%] vs. 13[20.0%]，p=0.017）。然而，根据 Cys C 水平定义的 CIN 发生率两组间无统计学差异（7[10.8%] vs. 7[10.8%]，p=1.000）。
结论
本研究表明，在患有糖尿病和 CKD 的患者中，羟苯磺酸钙对 CIN 无预防作用。
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