基于倾向性匹配法评价丹红注射液预防造影剂诱导的急性肾损伤的临床效果  

Clinical efficacy of Danhong injection in preventing contrast-induced acute kidney injury based on propensity score matching method

作　　者：汪江林[1] 周凌云[1] 尹文俊[1] 李岱阳 胡灿[1] 左笑丛[1,2] WANG Jianglin;ZHOU Lingyun;YINWenjun;LI Daiyang;HU Can;ZUO Xiaocong(Department of Pharmacy,Third Xiangya Hospital,Central South University,Changsha 410013;Center of Clinical Pharmacology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院药学部,长沙410013 [2]中南大学湘雅三医院临床药理中心,长沙410013

出　　处：《中南大学学报（医学版）》2020年第10期1193-1198,共6页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2018JJ6051);湖南省中医药科研计划(201760)。

摘　　要：目的:造影剂诱导的急性肾损伤(contrast-induced acute kidney injury,CI-AKI)已成为院内获得性急性肾损伤的第3位病因,而临床现有的水化疗法、抗氧化剂N-乙酰半胱氨酸等防治措施收效甚微。本研究基于倾向性匹配法评价丹红注射液对CI-AKI的预防效果。方法:选取在某三级甲等医院接受冠状动脉造影、经皮冠状动脉介入治疗、增强CT或血管介入手术等使用造影剂的患者12 867名,其中丹红治疗组423例,非丹红治疗组12 444例;利用倾向性匹配法,均衡2组患者的混杂因素,比较匹配后2组CI-AKI的发生情况。结果:共423对患者匹配成功。匹配后,丹红治疗组和非丹红治疗组的发生率分别为2.4%(10/423)和5.7%(24/423),非丹红治疗组CI-AKI的发生率高于丹红治疗组,差异有统计学意义(P<0.05)。2组中主要发生的CI-AKI均为1期,且非丹红治疗组1期CI-AKI的人数比丹红治疗组多,差异有统计学意义(P<0.05),而2期及3期CI-AKI在2组中的发生例数均较少,2组间差异无统计学意义(P>0.05)。结论:丹红注射液对1期CI-AKI具有预防作用。Objective: Contrast-induced acute kidney injury(CI-AKI) is the third cause of hospitalacquired AKI, and existing clinical prevention and treatment measures such as hydration therapy and/or administration of antioxidants N-acetylcysteine treatment and other treatments still show little effect on the prevention and treatment of CI-AKI. This study aims to explore the effect of Danhong injection on prevention of CI-AKI.Methods: A total of 12 867 patients, who received coronary angiography, percutaneous coronary intervention, enhanced CT or vascular intervention in a tertiary hospital, were enrolled for this study. Among them, 423 in the treatment group received intravenous drip of Danhong injection, and 12 444 in the control group received routine medicine.Propensity score matching was conducted to balance confounding factors between the 2 groups and then the prevention effect of Danhong injection on CI-AKI was compared between them.Results: A total of 423 pairs of patients were matched successfully. The incidence of CIAKI in the non-Danhong control group was higher than that in the Danhong treatment group(5.7% vs 2.4%). The difference between the 2 groups was statistically significant(P<0.05). CI-AKI occurred maily in the Stage 1 in both the non-Danhong control group and the Danhong treatment group. The number of patients with Stage 1 of AKI in the control group was more than that in the treatment group, and the difference was statistically significant(P<0.05). The incidence of AKI in Stage 2 and Stage 3 was less in both groups,and the difference was not statistically significant(P>0.05).Conclusion: The results of this study support the use of Danhong injection in the prevention of the Stage 1 of CI-AKI.

关 键 词：造影剂 急性肾损伤 丹红注射液 倾向性匹配法 

分 类 号：R277.5[医药卫生—中医学]