依达拉奉联合瑞舒伐他汀对高血压患者PCI术后对比剂肾病的预防作用

Protective Effects of Rosuvastatin Combined with Edaravone in Patients with Contrast-induced Nephropathy Complicated with Hypertension Undergoing Percutaneous Coronary Intervention

目的:探讨依达拉奉联合瑞舒伐他汀对高血压患者经皮冠状动脉介入治疗(PCI)后对比剂肾病的预防作用,旨在为高血压患者PCI术后的治疗提供参考。方法:选择120例择期行PCI术的高血压患者,随机分为依达拉奉组(ED组)、瑞舒伐他汀组(RO组)、依达拉奉与瑞舒伐他汀联合组(C组),各40例。ED组给予静脉滴注生理盐水100 mL+依达拉奉30 mg,每12小时一次;RO组给予瑞舒伐他汀10 mg口服,每晚一次;C组将2者联合应用。所有患者均于术前3天开始用药。观察3组患者入院时及术后第1天血尿素氮(BUN)、肌酐(Scr)、血清胱抑素(Cys C)、血清丙二醛(MDA)、超氧化物歧化酶(SOD)以及对比剂肾病的发病率。结果:ED组、RO组、C组CIN的发病率分别为10%、7.5%、2.5%,C组CIN发病率明显低于ED组与RO组,差异有统计学意义(P<0.05)。术后C组Scr、BUN、Cys C、MDA浓度明显低于ED组与RO组(P<0.05),SOD含量高于ED组与RO组(P<0.05)。结论:依达拉奉联合瑞舒伐他汀能明显降低高血压患者PCI术后对比剂肾病的发病率,机制可能与抗氧化应激反应有关。

Objective： To investigate the protective effect of edaravone combined with rosuvastatin treatment in patients with contrast induced nephropathy complicated with hypertension undergoing percutaneous coronary intervention（PCI）. Methods： 120 cases were randomly divided into edaravone group （group ED）, rosuvastatin group （group RO）, edaravone and rosuvastatin combination group （C group）, with 40 cases in each group. Patients in ED group were given intravenous saline 100ml combined with edaravone 30mg with once every 12 hours; patients in RO group received oral rosuvastatin 10mg with once a night; and patients in C group would be the combination of the 2 methods. All patients were performed with 3 days before the start of medication. The patients in 3 groups were observed of blood urea nitrogen （BUN）, creatinine （Scr）, serum cystatin C （Cys C）, malondialdehyde （MDA）, superoxide dismutase （SOD） on admission and first days after operation, and the incidence of contrast induced nephropathy were calculated. Results： The morbidity of CIN in ED group, RO group and C group were 10%, 7.5% and 2.5% respectively, incidence in C group was significantly lower than that in ED group and RO group, the difference was statistically significant （P〈0.05）. Postoperative concentration of Scr, BUN, Cys C, MDA in C group was lower than that in the ED group and RO group （P〈0.05）, the content of SOD was higher than ED group and RO group （P〈0. 05）. Conclusion： Application of edaravone combined with rosuvastatin could significantly reduce hypertension patients after PCI incidence contrast-induced nephropathy, and possible mechanisms was alleviating oxidative stress reaction.