阿托伐他汀对冠心病伴糖尿病患者的肾脏保护作用的临床观察

Clinical Observation about Effection of Atorvastatin on Preventing Renal Function in Patients with Coronary Heart Disease and Diabetes Mellitus

目的研究阿托伐他汀对冠心病伴有糖尿病患者进行冠状动脉造影及介入治疗后的肾脏保护作用。方法选取60例冠脉造影及70例冠脉介入治疗的冠心病伴糖尿病肾损伤的患者分为两组,再随机分为常规剂量阿托伐他汀组和较大剂量阿托伐他汀组,分别检测患者术前、术后1天、术后2天、术后5天患者血浆CRP;血浆胱抑素C(Cys C);测Scr;测尿α1-微球蛋白(α1-MG)、尿转铁蛋白(TRF)和尿微量白蛋白(mALB),肾小球滤过率(eGFR)。结果两组患者中常规剂量阿托伐他汀组较较大剂量阿托伐他汀组CRP及Cys C水平升高,差异有统计学意义(P<0.01);尿微量白蛋白水平也明显升高,差异有统计学意义(P<0.01);Scr及eGFR水平则差异无统计学意义(P>0.05)。而介入治疗组中常规剂量阿托伐他汀组较较大剂量阿托伐他汀组较造影组患者CRP及Cys C水平升高,差异有统计学意义(P<0.01);尿微量白蛋白水平也明显升高,差异有统计学意义(P<0.01);Scr及eGFR水平则差异无统计学意义(P>0.05)。结论造影剂能造成冠心病伴糖尿病患者出现肾损伤,而较大剂量阿托伐他汀可有效预防造影剂对肾脏的损伤作用。

Objective To observe the protection of renal function in patients with coronary heart disease and diabetes mellitus.Methods 60 patients with coronary arteriography we chosed,and 70 patients with coronary intervention therapy,they are divided into 2 groups randomly.Group one they used 20mg atorvastatin,the other group used 40mg atorvastatin.We Compared about CRP,Cys C,α1-MG, TRF,mALB and eGFR at before,1 day,2 days and 5 days.Results Patients used 20mg atorvastatin had higher levels of CRP,Cys C,α1-MG,TRF and mALB in both groups（P0.01）,and there is no change in Scr,eGFR（P0.05）.Conclusions Contrast induced nephropathy（CIN） can be induced after CAB or PCI,and 40mg atorvastatin can protect renal function,reduced the ratio of CIN.