摘要
目的:探讨大剂量阿托伐他汀(80mg)在预防老年(年龄≥60岁)急诊经皮冠状动脉内介入治疗术(急诊PCI)后造影剂相关肾病(CIN)的作用。方法:将2009-09-2011-03住院行急诊PCI术治疗的老年急性心肌梗死患者85例随机分为大剂量阿托伐他汀组和常规剂量阿托伐他汀组。2组患者在水化治疗的基础上,大剂量阿托伐他汀组在入院后即刻口服阿托伐他汀80mg,急诊PCI术后3d内每日口服阿托伐他汀40mg;常规剂量阿托伐他汀组入院后即刻及急诊PCI术后3d内每日口服阿托伐他汀20mg。然后分别测定并比较2组患者造影后24、72h的血清尿素氮(BUN)、血清肌酐(Scr)、内生肌酐清除率(Ccr)以及造影剂肾病(CIN)的发生率。结果:急诊PCI术后72h大剂量阿托伐他汀组BUN及Scr增加值和增加百分比明显低于常规剂量阿托伐他汀组(P<0.05),Ccr下降值和下降比率以及CIN的发生率(13.95%∶33.33%)亦明显低于常规剂量阿托伐他汀组(P<0.05)。结论:应用大剂量阿托伐他汀可能对老年患者急诊PCI术后CIN的发生具有一定的预防保护作用。
Objective：To investigate the preventive effect of high dose statins（80 mg） for elderly patients on contrast induced nephropathy（CIN） after emergency percuta-neous coronary intervention（PCI）.Method：Before emergency PCI,85 cases（≥60 years） with acute myocardial infarction from September 2009 to March 2011 were ran-domly divided into two groups： high dose atorvastatin group and regular dose atorvastatin group.On the basis of the hydration therapy,The patients of high dose atorvastatin groups received atorvastatin 80 mg orally instantly before emergency PCI and 40 mg once a day after emergency PCI in three days;The patients of regular dose atorvastatin groups received atorvastatin 20 mg orally instantly before emergency PCI and once a day after emergency PCI in three days.Then BUN,Scr,Ccr and incidence rate of CIN were measured and compared 24 hours and 72 hours after emergency PCI between groups.Contrast agents are used non-ionic low osmolar contrast media iohexol and record usage.Result：72 hours after emergency PCI,BUN and Scr values and percentage of increase,Ccr values and percentage of decline and the incidence of CIN（13.95% vs 33.33%） in high dose atorvastatin group was significantly lower than regular dose atorvastatin group（P0.05）.Conclusion：High dose atorvastatin can be of some preventive and protective value to CIN for the elderly patients after emergency PCI.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2011年第10期757-759,共3页
Journal of Clinical Cardiology
关键词
急性心肌梗死
降脂药
他汀类
造影剂肾病
保护
antilipemic agents
statins
acute myocardial infarction
contrast induced nephropathy
protection
