Catheter Cardiovasc Interv:心导管内的离子与非离子造影剂的1年死亡率研究

2016-06-03 Seven L MedSci原创

慢性肾脏病患者接受心导管检查,使用离子型低渗对比剂与非离子造影剂相比,有数值更低的死亡率。该随机前瞻性对照双盲多中心研究共纳入了146名稳定的慢性肾脏病接受动脉导管术的高危患者。稳定的慢性肾脏病被定义为连续2次血清肌酐值超过1.5 mg/dL和至少3 mg/dL。患者被随机分为低渗对比剂碘克酸(Hexabrix, Guerbet; n = 74) 或非离子等渗造影剂碘克沙醇(Visipaque,

慢性肾脏病患者接受心导管检查,使用离子型低渗对比剂与非离子造影剂相比,有数值更低的死亡率。

该随机前瞻性对照双盲多中心研究共纳入了146名稳定的慢性肾脏病接受动脉导管术的高危患者。稳定的慢性肾脏病被定义为连续2次血清肌酐值超过1.5 mg/dL和至少3 mg/dL。患者被随机分为低渗对比剂碘克酸(Hexabrix, Guerbet; n = 74) 或非离子等渗造影剂碘克沙醇(Visipaque, GE Healthcare; n = 72)。

以0-3天血清肌酐水平的中位数峰值增加为主要终点。主要目的是1年内死亡率、心肌梗死和冠状动脉血运重建术(PCI或CABG)的差异分析。患者在30天和1年时通过电话随访。

在30天,碘克酸组死亡1人(1.4%),碘克沙醇组死亡4人 (5.7%; RR = 0.24; 95% CI, 0.03-2.06)。急性肾功能衰竭发生在碘克酸组与碘克沙醇组分别有14和18人 (24.3% vs. 20%; RR = 1.22; 95% CI, 0.66-2.25)。透析分别有3和1人(4.1% vs. 1.4%; RR = 2.84; 95% CI, 0.3-26.64)。

1年后,研究人员发现碘克酸组全因死亡率更低(4.1% vs. 13.6%; RR = 0.3; 95% CI, 0.09-1.07)。碘克酸组的死因主要有:MI(n = 1)、心脏骤停(n = 1)和未知的原因(n = 1)。碘克沙醇组,死亡原因主要有:HF (n = 4)、急性肾功能衰竭(n = 1)、MI(n = 1)、心脏骤停(n = 1)和特发性肺纤维化(N = 1)。

研究人员观察到两组间MI (1.4% vs. 1.5%; RR = 0.9; 95% CI, 0.06-14.17)和再次血运重建(6.8% vs. 9.1%; RR = 0.75; 95% CI, 0.24-2.35)不存在差异。

“接受冠状动脉造影手术高危患者,低渗对比剂碘克酸和非离子等渗对比剂碘克沙醇之间,其1年死亡率不存在显著差异,”研究人员写道,“考虑到全因死亡率的组间差异,在以后还需要适当设计的临床试验来证实。”

原始出处:

Giustino G, et al. One-year results of the ICON (ionic versus non-ionic contrast to obviate worsening nephropathy after angioplasty in chronic renal failure patients) Study.Catheter Cardiovasc Interv. 2016;doi:10.1002/ccd.26106.

ICON: 1-year mortality lower with ionic vs. nonionic contrast medium during cardiac catheterization.Healio.June 2, 2016

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    2017-04-07 quxin068
  2. [GetPortalCommentsPageByObjectIdResponse(id=1938557, encodeId=afb9193855e05, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Apr 07 03:40:00 CST 2017, time=2017-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146126, encodeId=08441461269d, content=谢谢谢谢指点, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Tue Oct 11 22:41:37 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122125, encodeId=31a6122125b5, content=己拜读,受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 09:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88653, encodeId=1b428865312, content=不错的文章,多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Sun Jun 05 21:16:00 CST 2016, time=2016-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88527, encodeId=fdd18852eb8, content=不错的文章,多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Sun Jun 05 14:50:00 CST 2016, time=2016-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494000, encodeId=70661494000d6, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Sun Jun 05 10:40:00 CST 2016, time=2016-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88410, encodeId=9125884104f, content=翻译有问题, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=131a85729, createdName=1381516dc4m, createdTime=Sat Jun 04 08:38:00 CST 2016, time=2016-06-04, status=1, ipAttribution=)]
    2016-10-11 1e0ece0dm09(暂无匿称)

    谢谢谢谢指点

    0

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    2016-09-11 1e10c84am36(暂无匿称)

    己拜读,受益匪浅

    0

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    2016-06-05 沉心多思

    不错的文章,多学习

    0

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    2016-06-05 沉心多思

    不错的文章,多学习

    0

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    2016-06-05 sodoo
  7. [GetPortalCommentsPageByObjectIdResponse(id=1938557, encodeId=afb9193855e05, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Apr 07 03:40:00 CST 2017, time=2017-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146126, encodeId=08441461269d, content=谢谢谢谢指点, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Tue Oct 11 22:41:37 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122125, encodeId=31a6122125b5, content=己拜读,受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 09:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88653, encodeId=1b428865312, content=不错的文章,多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Sun Jun 05 21:16:00 CST 2016, time=2016-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88527, encodeId=fdd18852eb8, content=不错的文章,多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Sun Jun 05 14:50:00 CST 2016, time=2016-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494000, encodeId=70661494000d6, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Sun Jun 05 10:40:00 CST 2016, time=2016-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88410, encodeId=9125884104f, content=翻译有问题, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=131a85729, createdName=1381516dc4m, createdTime=Sat Jun 04 08:38:00 CST 2016, time=2016-06-04, status=1, ipAttribution=)]
    2016-06-04 1381516dc4m

    翻译有问题

    0