他汀类药物对冠状动脉造影围手术期造影剂肾病的预防研究

Role of statins in prevention of contrast-induced nephropathy after coronary arteriography-guided perioperation

目的分析经皮冠状动脉造影患者接受他汀类药物治疗后,围手术期前后早期肾损伤标记物水平的变化,探讨他汀类药物在预防造影剂肾病的作用。方法选择行冠状动脉造影的患者1 26例,随机分为对照组61例和他汀类药物治疗组(他汀组)65例,检测2组患者围手术期前后血肌酐、早期肾损伤标记物血清胱抑素C及高敏C反应蛋白水平的变化,并进行比较。结果他汀组和对照组术后血清高敏C反应蛋白较术前明显升高[(4.0±0.5)mg/L vs(2.2±0.6)mg/L,(5.2±0.9)mg/L vs(2.1±0.4)mg/L,P<0.01]。他汀组术后血清胱抑素C水平较对照组明显降低[(1.3±0.2)mg/Lvs(1.7±0.4)mg/L,P<0.01]。结论造影剂肾病可能与造影剂介导的炎性反应相关,他汀类药物可能通过拮抗炎性反应及氧化应激机制等预防该病的发生。

Objective To study the role of statins in prevention of contrast-induced nephropathy （CIN） by analyzing the changes of early renal injury biomarker levels in patients who underwent coronary arteriography（CAG）-gnided operation after teatment with statins. Methods One hun- dred and twenty-six patients who underwent CAG-guided operation were divided into control group（n = 61） and statin treatment group （n = 65）. Their serum levels of creatinine, cystatin C （Cys C）,an early renal injury biomarker,and high sensitivity C-reactive protein（hs-CRP） were measured and compared. Results The hs-CRP and Cys C levels were significantly higher in statin treatment group and control group after operation than before operation（4.0±0.5 mg/L vs 2.2± 0.6 mg/L,5.2±0.9 mg/L vs 2.1±0.4 mg/L,P〈0.01） ,while the Cys C level was significantly lower in statin treatment group than in control group（1.3±0.2 mg/L vs 1. 74-0.4 mg/L,P〈 0. 01）. Conclusion CIN may be related with contrast-induced inflammatory reactions. Satains prevent its occurrence possibly by antagonizing inflammatory reactions and oxidative stress.