摘要
目的：探讨强化阿托伐他汀预防急性冠脉综合征患者经皮冠脉介入治疗（PCI）术后造影剂肾病的作用。方法将2012年10月～2014年2月东莞市人民医院收治的符合急性冠脉综合征诊断并实施急诊PCI的患者100例随机分为对照组和实验组,每组50例。实验组：在急诊PCI术前给予阿托伐他汀负荷量80 mg,术后40 mg/d维持3 d,之后20 mg/d长期应用；对照组：PCI术后给予常规剂量阿托伐他汀20 mg/d长期应用。观察造影剂肾病和主要不良临床事件（心源性死亡、再梗死、靶血管再次血运重建、心功能不全加重、心绞痛发作等）发生情况。分别测定并比较两组患者PCI术前及术后24、48、72 h的血清肌酐（Scr）、胱抑素C、内生肌酐清除率（Ccr）水平。结果实验组治疗后48、72 h Scr水平分别为（93.5±17.2）、（84.3±14.3）μmol/L,明显低于对照组[（112.7±23.4）、（95.4±17.8）μmol/L],差异均有高度统计学意义（P〈0.01）；实验组治疗后24 h胱抑素C水平为（0.52±0.15）mg/L,明显低于对照组[（0.62±0.14）mg/L],差异有高度统计学意义（P〈0.01）；实验组造影剂肾病发病率为2.0%（1/50）,对照组为16.0%（8/50）,差异有统计学意义（P〈0.05）；实验组治疗后48、72 h Ccr水平为（89.4±8.3）、（92.3±7.3）mL/min,明显高于对照组[（79.3±10.3）、（87.5±8.4）mL/min],差异有高度统计学意义（P〈0.01）；实验组总不良心脏事件发生率为6.0%（3/50）,明显低于对照组[22.0%（11/50）],差异有统计学意义（P〈0.05）。结论强化阿托伐他汀对PCI术后造影剂肾病的发生具有一定的预防作用。
Objective To investigate the effect of intensive Atorvastatin for intervention of contrast induced nephropathy after percutaneous coronary intervention （PCI） in patients with acute coronary syndrome. Methods One hundred cases of patients confirmed to the diagnosis of acute coronary syndrome and taken emergency PCI admitted to Dongguan People＆#39;s Hospital from October 2012 to February 2014 were randomly divided into control group and experimental group, with 50 cases in each group. Experimental group： before emergency PCI, the patients were given 80 mg of Ator-vastatin load capacity, 40 mg/d for 3 days after PCI, then 20 mg/d for a long-term treatment; control group： after PCI, the patients were given 20 mg/d of Atorvastatin for a long-term treatment. The occurrence of contrast induced nephropathy and main clinical adverse events （cardiac death, recurrent cerebral infarction, target vessel revasculariza-tion, aggravation of heart failure, angina pectoris attack, etc） were observed. The levels of serum creatinine （Scr）, cys-tatin C, endogenous creatinine clearance rate （Ccr） before PCI and 24, 48, 72 h after PCI of the two groups were deter-mined and compared respectively. Results After treatment, the levels of Scr after treatment for 48, 72 h in the experi-mental group were （93.5＆#177;17.2）, （84.3＆#177;14.3） μmol/L respectively, which were lower than those of control group [（112.7＆#177;23.4）, （95.4＆#177;17.8）μmol/L], the differences were statistically significant （P＆lt;0.01）;the level of cystatin C after treatment for 24 h in the experimental group was （0.52＆#177;0.15） mg/L, which was lower than that of control group [（0.62＆#177;0.14） mg/L], the difference was statistically significant （P ＆lt; 0.01）;the incidence of contrast induced nephropathy in the＆amp;nbsp;experimental group was 2.0% （1/50）, which of control group was 16.0% （8/50）, the difference was statistically signifi-cant （P＆lt;0.05）;the levels of Ccr after treatment for 48, 72 h in the experimental group were （89.4＆#177;8.3）, （92.3＆#177;7.3） mL/min, which were higher than those of control group [（79.3＆#177;10.3）, （87.5＆#177;8.4） mL/min], the differences were statistically signifi-cant （P＆lt; 0.01）; the total incidence of adverse cardiac events in the experimental group was 6.0% （3/50）, which was lower than that of control group [22.0% （11/50）], the difference was statistically significant （P＆lt; 0.05）. Conclusion In-tensive Atorvastatin for contrast induced nephropathy after PCI has a certain prevention for the occurrence of contrast induced nephropathy.
出处
《中国医药导报》
CAS
2015年第18期114-118,125,共6页
China Medical Herald
基金
广东省东莞市科技计划医疗卫生类科研一般项目(201210515000103)
关键词
强化阿托伐他汀
经皮冠脉介入治疗
造影剂肾病
预防
Intensive Atorvastatin
Percutaneous coronary intervention
Contrast induced nephropathy
Prevention
