不同剂量他汀对心脏瓣膜置换术后肾功能影响的临床研究

Effects of Different Doses of Atorvastatin on Kidney for Patients with Valve Replacement

目的 探讨不同剂量阿托伐他汀钙片对心脏瓣膜置换术后肾功能的影响.方法 以行心脏瓣膜置换术的88例患者进行前瞻性研究,根据阿托伐他汀钙片的使用剂量随机分为两组,即常规剂量组（20 mg/d）和强化剂量组（40 mg/d）,检测所选患者术前、术后72 h以及术后7 d肾功能、肝功能,比较两组患者各指标情况并分析.结果 两组患者术前肾功能差异无统计学意义（P〉0.05）,术后72 h、术后7 d血肌酐、血尿素氮均较术前明显升高,差异有统计学意义（P〈0.05）;且强化剂量组术后72 h血肌酐、血尿素氮水平较常规剂量组低,差异有统计学意义（P〈0.05）.在肝功能,强化剂量组与常规剂量组,术前术后差异无统计学意义（P〉0.05）.结论 心脏瓣膜置换术在手术前后服用大剂量的他汀类药物,能明显保护患者术后肾功能,且对肝脏不产生副作用,可预防手术过程中造成肾功能损伤.

Objective To investigate the effects of different doses of atorvastatin on renal function after cardiac valve replacement. Methods 88 patients with cardiac valve replacement were enrolled in this study. 88 patients were randomly divided into two groups according to the dose of atorvastatin calcium tablets： conventional dose group （20 mg/d） and intensive dose group （40 mg/d）. The renal function and liver function before operation and 72 h, 7 d after operation were examined, to compare and analyze the indicators of the patients in the two groups.Results There was no significant difference in the renal function before operation between the two groups （P〉0.05）. The serum creatinine and blood urea nitrogen at 72 h, 7 d after operation were significantly higher than those before operation （P〈0.05）, serum creatinine and blood urea nitrogen levels were lower than those in the conventional dose group at 72 h after operation, the difference was statistically significant （P〈0.05）. There was no significant difference in liver function of intensive dose group and conventional dose group before and after operation （P〉0.05）. Conclusion Taking large doses of statins before and after cardiac valve replacement surgery can significantly protect the patient＇s postoperative renal function without side effect on the liver, and can prevent the process of causing renal damage.