强化阿托伐他汀联合尼可地尔注射液对经皮冠状动脉介入治疗后患者造影剂肾病发生的影响

Effect of intensive atorvastatin combined with nicorandil injection on contrast-induced nephropathy after percutaneous coronary intervention

目的探讨强化阿托伐他汀联合尼可地尔注射液对经皮冠状动脉介入(PCI)治疗后患者造影剂肾病(CIN)发生的影响。方法选择2017年2月至2018年2月在中国人民解放军联勤保障部队第900医院因行PCI治疗162名冠心病患者。根据围手术期他汀治疗方案不同分为强化阿托伐他汀治疗,A组54例;尼可地尔治疗,B组50例;强化阿托伐他汀联合尼可地尔治疗,C组58例,所有患者PCI术前及术后第1天检测超敏C反应蛋白(HsCRP)、尿微量白蛋白/肌酐比值(ACR)和肾功能血肌酐(Scr)水平。结果术后第1天,B组患者的各项指标均高于术前,A和C组患者的术后Hs-CRP、Scr和ACR均低于术前,差异有统计学意义(P<0.05)。A组患者术后的Hs-CRP、Scr和ACR均高于C组患者,差异有统计学意义(P<0.05)。A组患者CIN发生率为5.56%(3/54),B组患者CIN发生率为10.00%(5/50),C组患者CIN发生率1.72%(1/58)。C组患者CIN发生率低于A组和B组患者,差异有统计学意义(P<0.05)。结论强化阿托伐他汀联合尼可地尔对PCI治疗后降低CIN发生率,具有良好的临床疗效,值得进一步深入研究和探讨。

Objective To investigate the effect of intensive atorvastatin combined with nicorandil injection on contrastinduced nephropathy(CIN) in patients after percutaneous coronary intervention(PCI). Method From February 2017 to February 2018, 162 patients with coronary heart disease were treated by PCI in the 900 th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army. According to the different treatment schemes of statin during perioperative period, the patients were divided into intensive atorvastatin group A(54 cases);nicorandil group B(50 cases);intensive Atorvastatin Combined with nicorandil group C(58 cases). All patients were tested for hypersensitive C-reactive protein(Hs-CRP) and urinary microalbumin/creatinine ratio(ACR) before and on the first day after PCI. And renal function blood creatinine(SCR) levels. Result On the first day after operation, the indexes of group B were higher than those before operation, and the Hs-CRP, Scr and ACR of group A and C were lower than those before operation, with statistical significance(P<0.05). Postoperative hs-CRP, Scr and A CR in group A were higher than those in group C(P<0.05). The incidence of CIN was 5.56%(3/54) in group A, 10.00%(5/50) in group B and 1.72%(1/58) in group C. The incidence of CIN in group C was lower than that in group A and group B(P<0.05). Conclusion Intensified atorvastatin combined with nicorandil has good clinical efficacy in reducing the incidence of CIN after PCI, which deserves further study and discussion.