基于铁死亡标记物探讨黄蜀葵花制剂防治碘对比剂诱导的急性肾损伤的临床研究OA

Objective To investigate the clinical efficacy and potential mechanism of Abelmoschi Corolla preparation(Jiahua Tablets)in the prevention and treatment of iodinated contrast media(ICM)-induced acute kidney injury(CI-AKI)through blood homocysteine(HCY),reduced glutathione(GSH),4-hydroxynonenal(4-HNE)and renal injury markers.Methods A prospective,randomized controlled study was conducted.A total of 100 patients who underwent coronary computed tomography angiography(CTA)or coronary intervention in the Department of Cardiology of Affiliated Hospital of Nanjing University of Chinese Medicine from February to October 2025 were enrolled and randomly divided into control group and treatment group by random number table method,with 50 cases in each group.The control group received standard basic treatment including statins(Rosuvastatin Calcium Tablets),and the treatment group received Jiahua Tablets on the basis of the control group.The medication was initiated 3 days before ICM administration,with continuous medication for 7 days.The changes of serum HCY,GSH,4-HNE,serum creatinine(SCr),cystatin C(Cys C)and creatinine clearance rate(Ccr)levels(i.e.,3 days before ICM administration and 3 days after ICM administration)were observed before and after treatment in both groups.Results(1)After treatment,the serum levels of SCr,Cys C and HCY in the treatment group were significantly decreased compared with those before treatment(P＜0.05),while no significant changes were observed in the control group(P＞0.05).Intergroup comparison showed that the serum levels of SCr,Cys C and HCY in the treatment group were significantly lower than those in the control group,with statistically significant differences(P＜0.05 or P＜0.01).(2)After treatment,the Ccr level in the treatment group showed no significant change compared with that before treatment(P＞0.05),while the Ccr level in the control group was significantly decreased(P＜0.05).Intergroup comparison showed that the Ccr level in the treatment group was significantly higher than that in the control group,with statistically significant difference(P＜0.05).(3)After treatment,the serum levels of GSH and 4-HNE in the treatment group showed no significant changes compared with those before treatment(P＞0.05).In the control group,the serum GSH level was significantly decreased and the serum 4-HNE level were significantly increased(P＜0.05)compared with those before treatment.Intergroup comparison showed that the serum GSH level in the treatment group was significantly higher than that in the control group,and the serum 4-HNE level was significantly lower than that in the control group,with statistically significant differences(P＜0.05 or P＜0.01).Conclusion Abelmoschi Corolla preparation(Jiahua Tablets)has certain preventive and therapeutic effects on ICM-induced CI-AKI,and its mechanism may be related to the inhibition of ferroptosis.