强化阿托伐他汀治疗对慢性肾病患者经皮冠状动脉介入治疗术后对比剂肾病的影响

Clinical effects of strengthen atorvastatin on contrast-induced nephropathy after percutaneous coronary intervention

目的总结阿托伐他汀强化治疗对慢性肾病患者经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)的影响。方法选择2010年6月至2012年11月我院收治的120例行PCI治疗的慢性肾病患者为研究对象,随机分为观察组和对照组各60例,观察组患者术前给予80 mg阿托伐他汀强化治疗,对照组术前给予20 mg阿托伐他汀治疗,分别于手术前、术后3 d监测血清肌酐(Scr)、血浆胱抑素(Cys C),并根据Cockcroft-Gault计算内生肌酐清除率(Ccr)。结果观察组患者术后CIN发生率(11.67%)低于对照组(16.67%),但差异无统计学意义(P>0.05);观察组患者术后肾功能指标改善幅度大于对照组,差异具有统计学意义(P<0.05);观察组患者住院时间(8.11±3.15)d明显短于对照组(11.26±3.12)d,差异具有统计学意义(P<0.05);观察组不良事件发生率(13.33%)低于对照组(20.00%),但差异无统计学意义(P>0.05)。结论慢性肾病患者在PCI前强化阿托伐他汀治疗能减轻肾损伤,但在CIN的预防没有显著作用。

Objective To investigate clinical effects of strengthen atorvastatin on contrast-induced nephropathyn（CIN） after percutaneous coronary intervention（PCI）. Methods 120 cases of patients with chronic kidney disease after PCI in our hospital from June 2010 to November 2012 were divided into the observation group（n=60）, treated by atorvastatin intensive treatment（80 mg） and the control group（n=60）. The SCR（serum creatinine）, Cys C（plasma cystatin）of two groups were analysed before and after surgery 3 d and Ccr（endogenous creatinine clearance） was calculated according to the Cockcroft-Gault. Results The postoperative incidence of CIN of the observation group（11.67%） was lower than that of the control group（16.67%）, but the difference was not significant（P〉0.05）. The postoperative renal function improvement of the observation group was better than that of the control group（P〈0.05）. Age, tumor size, tumor grade, metastasis or recurrence and family history between triple-negative breast cancers and non-triple negative breast cancer were significant（P〈0.05）. The hospitalized time of observation group[（8.11±3.15）d] was shorted than that of the control group[（11.26±3.12）d]（P〈0.05）. Conclusion The intensive atorvastatin therapy before PCI can reduce renal damage,but it is not conducive to the prevention of CIN.