Zhao Ying, Wang Haiyan, Zhao Jiayu, Wang Xun, Wang Yanbo, Li Wei, Song Tingting, Hao Guozhen, Fu Xianghua, Gu Xinshun
Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
Pulm Circ. 2020 Oct 26;10(4):2045894020903953. doi: 10.1177/2045894020903953. eCollection 2020 Oct-Dec.
This study aimed to explore the correlation of sodium ferulate and the renal protective effect on computed tomography pulmonary angiography in patients suffering from pulmonary hypertension. This prospective study enrolled 92 consecutive patients with pulmonary hypertension diagnosed by echocardiography, and all included patients underwent computed tomography pulmonary angiography after admission. The participants were randomized, divided into sodium ferulate group ( = 49) and control group ( = 43), of which patients in the sodium ferulate group received intravenous sodium ferulate 3.0 g per day from 12 h before computed tomography pulmonary angiography examination to 72 h after that, and patients in the control group were provided with routine treatment. Renal function was assessed by measuring serum creatinine, estimated glomerular filtration rate, Cystatin-C as well as 24 h, 48 h, and 72 h after computed tomography pulmonary angiography, followed by the calculation of the incidence of contrast-induced nephropathy for contrast-induced nephropathy and non-contrast-induced nephropathy grouping. Besides, renal resistive index was determined via Doppler ultrasound examination before, after 1 h and 24 h after computed tomography pulmonary angiography. There were no significant differences between the two groups in serum creatinine at baseline and 24 h after computed tomography pulmonary angiography ( > 0.05, respectively), but at 48 h and 72 h, it was lower in the sodium ferulate group ( < 0.05). There were no significant differences of estimated glomerular filtration rate between the two groups ( > 0.05). The level of Cystatin-C at 48 h and 72 h after computed tomography pulmonary angiography was lower than in the sodium ferulate group ( < 0.05). Contrast-induced nephropathy was identified in nine patients (9.78%). Sodium ferulate was associated with a decline in the incidence of contrast-induced nephropathy (4.08 vs. 16.28 %, < 0.05). Compared to patients with contrast-induced nephropathy, lower renal resistive index were observed at 1 h and 24 h after computed tomography pulmonary angiography in patients without contrast-induced nephropathy ( < 0.05). Infusion of sodium ferulate before and after computed tomography pulmonary angiography was associated with a decline in incidence of contrast-induced nephropathy.
本研究旨在探讨阿魏酸钠与肺动脉高压患者计算机断层扫描肺动脉造影肾保护作用的相关性。这项前瞻性研究连续纳入了92例经超声心动图诊断为肺动脉高压的患者，所有纳入患者入院后均接受了计算机断层扫描肺动脉造影。参与者被随机分为阿魏酸钠组（n = 49）和对照组（n = 43），其中阿魏酸钠组患者在计算机断层扫描肺动脉造影检查前12小时至检查后72小时每天静脉输注阿魏酸钠3.0 g，对照组患者接受常规治疗。在计算机断层扫描肺动脉造影后24小时、48小时和72小时通过测量血清肌酐、估算肾小球滤过率、胱抑素-C评估肾功能，然后计算对比剂肾病和非对比剂肾病分组的对比剂肾病发生率。此外，在计算机断层扫描肺动脉造影前、造影后1小时和24小时通过多普勒超声检查测定肾阻力指数。两组在基线时和计算机断层扫描肺动脉造影后24小时的血清肌酐无显著差异（分别为P>0.05），但在48小时和72小时时，阿魏酸钠组较低（P<0.05）。两组估算肾小球滤过率无显著差异（P>0.05）。计算机断层扫描肺动脉造影后48小时和72小时的胱抑素-C水平低于阿魏酸钠组（P<0.05）。9例患者（9.78%）被诊断为对比剂肾病。阿魏酸钠与对比剂肾病发生率下降相关（4.08%对16.28%，P<0.05）。与发生对比剂肾病的患者相比，未发生对比剂肾病的患者在计算机断层扫描肺动脉造影后1小时和24小时观察到较低的肾阻力指数（P<0.05）。计算机断层扫描肺动脉造影前后输注阿魏酸钠与对比剂肾病发生率下降相关。
