瑞舒伐他汀钙在预防急性冠脉综合征介入术造影剂肾病中的应用效果

Application effect of rosuvastatin calcium on prevention of contrast-in-duced nephropathy in the intervention operation for acute coronary syndrome

目的探讨瑞舒伐他汀钙在预防急性冠脉综合征（ACS）介入术造影剂肾病中的临床价值。方法选择2013年7月~2015年6月我院收治的ACS入院后行经皮冠状动脉介入治疗（PCI）的患者160例,将其随机分为治疗组和对照组,各80例。治疗组于术前2~3 d开始口服瑞舒伐他汀钙,对照组术前未用他汀类药物治疗,比较两组术前、术后第1和3天的尿微量白蛋白（m Alb）、血清胱抑素C（Cys-C）、超敏C-反应蛋白（hs-CRP）、血清肌酐（SCr）,并估测肾小球滤过率（eGFR）。结果术前,两组mAlb、Cys-C、hs-CRP、SCr、eGFR水平无显著差异（P〉0.05）,其中mAlb、SCr和e GFR水平在术后也无显著差异（P〉0.05）。术后第3天,治疗组的Cys-C水平无显著性变化,但对照组的Cys-C水平显著升高（P〈0.05）,即治疗组的Cys-C水平低于对照组（P〈0.05）;术后第3天,两组的hs-CRP水平显著高于术前（P〈0.05）,且治疗组的hs-CRP水平高于对照组（P〈0.05）。结论 ACS患者PCI术前给予瑞舒伐他汀钙强化治疗,可降低对比剂导致的肾脏功能损伤。

Objective To explore the clinical value of rosuvastatin calcium in prevention of contrast-induced nephropathy in the intervention operation for acute coronary syndrome（ACS）. Methods 160 patients with ACS who were given percutaneous coronary intervention（PCI） after admission in our hospital from July 2013 to June 2015 were selected and evenly divided into treatment group and control group in random, with 80 cases in each group.The treatment group was orally given enhanced rosuvastatin calcium before surgery 2 to 3 days.The control group was not given rosuvastatin before the operation.Urinary microalbumin（m Alb）,serum cystatin C（Cys-C）,high sensitive C reactive protein（hs-CRP）,erum creatinine（SCr） in two groups were compared before the operation and on the first and third day after the operation,and glomerular filtration rate（eGFR） was evaluated also. Results Before operation,there were no significant difference in mAlb、Cys-C、hs-CRP、SCr and eGFR between two groups（P〉0.05）, among,there was no significant difference in mAlb,SCr and eGFR after operation（P〉0.05）.The third day after operation,no significant difference of Cys-C in treatment group,but Cys-C levels in control group was significantly increased（P〈0.05）,and Cys-C level in treatment group was lower than of control group（P〈0.05）.The third day after operation,hs-CRP levels in two groups was significantly higher than that of before operation（P〈0.05）,and hs-CRP level in treatment group was higher than that of control group（P〈0.05）.Conclusion Rosuvastatin calcium intensive treatment for patients with ACS before PCI operation can reduce the damages of renal function induced by contrast.