强化阿托伐他汀治疗对冠心病合并高尿酸血症患者PCI后Scr、hsCRP、NGAL的影响

Impact of intensive atorvastatin treatment on levels of Scr,hsCRP and NGAL in patients with coronary heart disease complicated hyperuricemia after PCI

目的:观察大剂量阿托伐他汀对冠心病合并高尿酸血症(HUA)患者经皮冠状动脉介入治疗(PCI)术后血清肌酐(Scr)、高敏C反应蛋白(hsCRP)及中性粒细胞明胶酶脂质相关运载蛋白(NGAL)的影响,探讨阿托伐他汀对肾脏的保护作用。方法:择期PCI的冠心病合并HUA患者60例,随机分为阿托伐他汀强化治疗组(31例,围手术期40mg/d)和常规治疗组(29例)。分别于术前,术后24h、72h测定血清Scr、hsCRP、NGAL水平。结果:两组Scr水平在术后24h升高,72h回落,无显著差异(P>0.05);hsCRP、NGAL术后24h升高,强化治疗组升高程度明显低于常规治疗组[hsCRP(6.8±2.1)mg/L比(8.4±3.8)mg/L,NGAL(57.1±12.7)ng/ml比(66.2±17.9)ng/ml],P均<0.05;术后72h回落,与常规治疗组比较,强化治疗组hsCRP[(6.6±2.4)mg/L比(5.5±1.5)mg/L]、NGAL[(52.1±12.9)ng/ml比(45.6±9.7)ng/ml]水平均明显降低(P<0.05)。结论:短期内大剂量应用阿托伐他汀可以降低冠心病合并高尿酸血症患者PCI术后血清高敏C反应蛋白和中性粒细胞明胶酶脂质相关运载蛋白升高的程度,从而达到保护肾脏的作用。

Objective： To observe impact of large dose atorvastatin on levels of serum creatinine （scr）, mgn sensmve C reactive protein （hsCRP） and neutrophil gelatinase associated lipocalin （NGAL） in patients with coronary heart disease （CHD） complicated hyperuricemia （HUA） after percutaneous coronary intervention （PCI） and explore pro-r tective effect of atorvastatin on kidney. Methods： A total of 60 CHD patients with HUA undergoing selective PCI were randomly divided into intensive treatment group （n = 31, atorvastatin 40 mg/d in peroperative period） and routine treatment group （n = 29）. Serum levels of Scr, hsCRP and NGAL were measured before, 24h and 72h after PCI in two groups. Results： Scr level increased after PCI 24h and decreased after PCI 72h in two groups and there were no significant difference （P〉0.05） ; there were significant increase in levels of hsCRP and NGAL after PCI 24h, and those of intensive treatment group were significantly lower than those of routine treatment group [-hsCRP （6.8±2.1） mg/Lvs. （8.4±3.8） mg/L, NGAL （57.1±12.7） ng/mlvs. （66.2±17.9） ng/ml], P〈0.05 all; levels of hsCRP and NGAL decreased after PCI 72h, compared with routine treatment group, there were significant decrease inhsCRP [ （6.6±2.4） mg/Lvs. （5.5±1.5） mg/L], andNGAL[ （52.1±12.9） ng/mlvs. （45.6±9.7） ng/ml] in intensive treatment group （P〈0.05 both）. Conclusion： Large dose atorvastatin within short term can decrease elevatory extent of serum levels of high sensitive C reactive protein and neutrophil gelatinase associated lipocalin in patients with coronary heart disease complicated hyperuricemia after percutaneous coronary intervention, thereby protect kidney.