他汀类药物预防冠脉介入术后造影剂肾病的研究

Study of statins on prevention of contrast induced nephropathy after percutaneous coronary intervention

目的:探讨他汀类药物在预防冠脉介入术后(PCI)造影剂相关肾病(CIN)的作用。方法:将住院行冠状动脉介入治疗的冠心病患者138例随机分为他汀组和非他汀组。两组在水化治疗基础上,他汀组在应用造影剂前、后24 h,每日1次口服阿托伐他汀80 mg。然后分别测定并比较两组患者造影后24、72 h的血清尿素氮(BUN)、血清肌酐(Scr)、内生肌酐清除率(Ccr)以及造影剂肾病的发生率。造影剂均使用非离子型低渗造影剂碘海醇,记录使用量。结果:他汀组BUN及Scr增加值和增加百分比明显低于非他汀组(P<0.05),Ccr下降值和下降比率以及CIN的发生率(5.80%vs 15.94%)亦明显低于非他汀组(P<0.05)。结论:应用阿托伐他汀对于冠脉介入治疗患者造影剂肾病的发生具有一定的预防保护作用。

Objective： To study the protective effect of statins on prevention of contrast induced nephropathy （CIN） after percutaneous coronary intervention （PCI）. Methods： Before PCI, 138 cases with coronary heart disease were randomly divided into two groups： statin group and non-statin group. On the basis of the hydration therapy in two groups, the patients in statin group received atorvastatin 80 mg orally once a day 24 hours before and after contrast administration.Then BUN, Scr, Ccr and incidence rate CIN were measured and compared 24 hours and 72 hours after contrast administration between groups.Contrast agents were non-ionic low osmolar contrast media iohexol and dosage was recorded. Results： BUN and Scr values and percentage of increase, Ccr values and percentage of decline and the incidence of CIN（5.80% vs 15.94% ） in statin group was significantly lower than those in non-statin group（P〈0.05）. Conclusion：Atorvastatin has a good preventive and protective effect to CIN after percutaneous coronary intervention.