摘要
目的探讨前列地尔对冠状动脉造影患者发生对比剂肾病的预防作用。方法以"前列地尔、前列腺素E1、造影剂、对比剂肾病(造影剂肾病)、肾衰竭"为关键词,计算机检索万方数据库、中国期刊全文数据库、维普中文科技期刊、MEDLINE、Cochrane图书馆、Pub Med、EMBASE等中外文数据库中的随机对照试验,检索时间从1966年至2014年11月,无语种限制。两位评价者评价每一项研究的质量并提取数据。结果 8项随机对照研究共计1 391例患者被纳入研究。荟萃分析显示,使用前列地尔类药物后对比剂肾病的发生率差异有统计学意义[治疗组vs.对照组:4.4%vs.13.8%,相对危险度0.32,95%可信区间(0.22,0.48),P<0.000 01],且入选研究没有异质性(I2=0,P<0.05);前列地尔组术后48 h血清肌酐[均数差=-5.19,95%可信区间(-8.73,-1.65),P=0.004]、72 h血清肌酐[均数差=-8.20,95%可信区间(-13.09,-3.30),P=0.001]、48 h尿素氮[均数差=-1.02,95%可信区间(-1.65,-0.39),P=0.001]、72 h尿素氮[均数差=-0.68,95%可信区间(-1.30,0.06),P=0.03]较常规治疗组明显降低,差异有统计学意义。结论前列地尔对对比剂肾病有预防作用,同时对经皮冠状动脉介入治疗术后患者肾功能有保护作用。
Objective To assess the effects of Alprostadil on the prevention of contrast-induced nephropathy（CIN）. Methods We searched Wan Fang, CNKI, VIP, MEDLINE, Cochrane Library, Pub Med, EMBASE, with the key words ＂alprostadi / prostaglandin E1＂、 ＂contrast＂ and ＂nephropathy / nephrosis / nephrotoxicity / kidney failure＂ in all language from 1996 to 2014 for RCT that assess the prevention effects of Alprostadi on CIN. Results Eight trials with a total of 1 391 patients were identified. Analysis of the data in patients revealed significant difference in CIN incidence between the Alprostadil group and the placebo groups（4.4% vs. 13.8%）. The relative risk [RR =0.32, 95% CI（0.22,0. 48）, P 〈0. 000 01 ] was without evidence of heterogeneity（ I2= 0, P〈 0. 05）. 48 h levels of Scr [ MD =- 5. 19, 95 %CI（- 8.73,-1.65）,P=0.004], 72 h Scr [MD=-8.20,95%CI（-13.09,-3.30）,P=0.001], 48 h BUN [MD=-1.02,95%CI（-1.65,-0.39）,P =0.001], 72 h BUN [MD =-0.68,95% CI（-1.30,0.06）,P =0.03] were significantly lower than in placebo group after PCI（P〈0.05）. Conclusion Alprostadil may be beneficial in reducing the incidence of CIN and protect the renal function in CHD patients undergoing PCI.
出处
《循证医学》
CSCD
2015年第3期161-167,共7页
The Journal of Evidence-Based Medicine
