阿托伐他汀预防全脑血管造影后急性肾损伤的临床研究

Clinical research of atorvastatin on prevention of acute kidney injury after DSA

目的研究阿托伐他汀预防全脑血管造影术(DSA)后急性肾损伤的应用价值。方法将行DSA的患者分为对照组(n=42)和干预组(n=42),干预组患者于术前2 d开始口服阿托伐他汀。分别于术前24 h及术后6 h、24 h、48 h抽血检测血中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、胱抑素C(Cys C)和血肌酐(Scr)。结果两组患者术后6 h的血NGAL水平明显高于其他时间点,术后24 h Cys C水平明显高于其他时间点(P<0.05),对照组术后48 h Scr水平明显高于其他时间点(P<0.05);术后6 h干预组的血NGAL水平明显低于对照组(P<0.05),术后24 h干预组的Cys C水平明显低于对照组(P<0.05),术后48 h干预组的Scr水平明显低于对照组(P<0.05)。术后对照组发生急性肾损伤患者8例(19.05%),干预组患者术后发生急性肾损伤患者2例(4.76%),干预组患者术后肾损伤发生率明显低于对照组,差异有统计学意义(P<0.05)。结论造影剂对肾脏功能有一定损伤作用,应用阿托伐他汀对肾脏有一定保护效果,有预防造影后肾损伤的作用。

Objective To study the clinical value of atorvastatin in the prevention of acute renal injury after digital sub-traction angiography（ DSA）.Methods Patients underwent DSA were divided into control group（ n = 42） and intervention group（n = 42）.The intervention group were given oral atorvastatin 2 days before operation.And then, neutrophil gelatinase-as- sociated lipocalin（NGAL）,cystatin C （Cys C） and serum creatinine（Scr）were detected 24 h before operation, 6 h , 24 h and 48 h after operation, respectively.Results After operation NGAL level 6 h in both groups were higher than those at other time points,Cys Clevel 24 h were higher than those at other time points （P 〈0 .0 5 ） , and the Scr level 48 h was significantly higher than those at other time points（P〈0.05）.The blood NGAL level 6 h after operation in the intervention group was significantly lower than that in the control group （P 〈0 .0 5 ） ,the Cys C level 24 h after operation in the intervention group was significantly lower than that in the control group （P 〈0 .0 5 ） , and the Scr level 48 h after operation in the intervention group was significantly lower than that in the control group（P 〈0.05）.After operation,8 cases （19.05%） suffered from acute kidney injury in thecontrol group, and 2 cases （4.76%） suffered from it in the intervention group,the incidence of renal injury in the intervention group was significantly lower than that in the control group,so difference was statistically significant（ P〈0.05）.Conclusion Contrast media has some damages to renal function,atorvastatin can protect kidney and prevent renal injury after contrast.