强化阿托伐他汀治疗对冠心病患者PCI术后炎性因子及肾功能的影响

Effects of intensive atorvastatin on post-PCI inflammatory factor and renal function of CHD patients

目的探讨强化阿托伐他汀治疗对冠心病患者经皮冠状动脉介入治疗术后炎性因子及肾功能的影响。方法将108例冠心病患者采用随机数字表法分为A组和B组，每组54例。两组患者均于手术前1周予以常规治疗，在此基础上A组予以常规剂量阿托伐他汀治疗，B组予以强化阿托伐他汀治疗。于手术前后比较两组患者相关炎性因子水平及肾功能情况，观察两组患者不良反应发生情况。结果手术后两组患者C反应蛋白、白细胞介素-6和肿瘤坏死因子-a水平均显著高于手术前（P〈0．05或o．01），A组较B组升高更显著（P〈0．01）。手术后A组患者尿素氮、血肌酐和胱抑素水平均显著高于手术前（P〈0．01），肌酐清除率和肾小球滤过率水平均显著低于手术前（P〈o．01）；B组患者尿素氮、肌酐清除率和肾小球滤过率水平均显著高于手术前，血肌酐和胱抑素水平均显著低于手术前（P〈0．01）。手术后B组患者尿素氮、血肌酐和胱抑素水平均显著低于A组（P〈0．01），肌酐清除率和肾小球滤过率水平均显著高于A组（P〈0．01）。两组患者不良反应发生率比较差异无显著性（P〉0．05）。结论强化阿托伐他汀治疗可显著降低冠心病患者经皮冠状动脉介入治疗术后相关炎性因子水平，保护肾功能。

Objective To explore the fffects of intensive atorvastatin on inflammatory factor and renal function of coronary heart disease （CHD） patients after percutaneous coronary intervention （PCI）. Methods A total of 108 CHD patients were assigned to group A and B of 54 ones each according to random number table. Both groups received routine treatment in I week before operation, on this basis group A was plus routine dosage of atorvastatin and B plus intensive atorvastatin. Results After treatment C-reactive protein, interleukin-6 and tumor necrosis factor-a levels of both groups were significantly higher com- pared with pretreatment （P〈0.05 or 0.01）, so were those in group A than in B （P〈0.01）. After treat- ment urea nitrogen, serum creatinine and cystatin levels were significantly higher （P〈0.01） and creati- nine clearance and glomerular filtration rate lower （P〈0.01） compared with pretreatment in group A; urea nitrogen, creatinine clearance and glomerular filtration rate were significantly higher and serum creatinine and cystatin levels lower （P〈0.01） in B. After treatment urea nitrogen, serum creatinine and cystatin levels were significantly lower （P〈0.01） and creatinine clearance and glomerular filtration rate higher （P〈0.01） in group B than in A. There were no significant differences in the incidences of adverse reactions （P〈0.05）. Conclusion Intensive atorvastatin could notably lower post-PCI inflammatory factors levels of CHD patients and protect renal function.