阿托伐他汀钙片对接受经皮冠状动脉介入治疗的肾功能不全糖尿病患者的有效性分析

Efficacy of lipitor in diabetic patients with renal insufficiency undergoing percutaneous coronary intervention

目的评估阿托伐他汀钙片在预防造影剂肾病中的作用。方法前瞻性纳入610例肾小球滤过率为(47±12)mL·min-1·1.73 m-2的患者,随机(双盲)按1∶1比例分别接受阿托伐他汀钙片(80 mg/d,持续48 h)或安慰剂干预。在干预前、干预后72 h和10 d后测量血清肌酐和肾小球滤过率。结果纳入分组的糖尿病患者年龄为(56.5±7.0)岁(男性52%)。安慰剂组的血清肌酐浓度在经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后3 d显著增加,并在第10天下降至基线水平,但肌酐浓度仍然较高。在阿托伐他汀钙片组中,血清肌酐浓度在第3天没有显著上升,在第10天下降至低于基线的水平。阿托伐他汀钙片组造影剂肾病的发生率低于安慰剂组,差异有统计学意义(6.2%vs. 17.7%,P<0.05)。结论剂量为80 mg/d、持续48 h的阿托伐他汀钙片干预对PCI治疗后的糖尿病患者出现造影剂肾病具有抑制作用。

Objectives To evaluate the role of lipitor in the prevention of contrast-induced nephropathy (CIN).Methods A prospective enrollment of 610 patients with a mean glomerular filtration rate of(47±12)mL·min^-1·1.73 m^-2 was randomized(double-blind) to lipitor at a 1∶1 ratio(80 mg daily,48 hours) or placebo intervention.Serum concentration of creatinine and glomerular filtration rate were measured before,72 and 10 days after the intervention.Results Mean age of diabetic patients enrolled in the group was (56.5±7) years(52% for men).Mean serum concentration of creatinine in placebo group increased significantly 3 days after percutaneous coronary intervention(PCI) and fell to baseline level on day 10,but concentration of creatinine remained high.However,in lipitor group,mean serum concentration of creatinine did not increase significantly on day 3 and then fell to baseline level below on day 10.Incidence of CIN was significantly lower in lipitor group than that in placebo group(6.2% vs.17.7%,P<0.05).Conclusions Lipitor intervention with a dose of 80 mg/day for 48 hours has an inhibitory effect on CIN in diabetic patients after PCI.