阿托伐他汀联合普罗布考在行经皮冠状动脉支架置入术冠心病伴糖尿病患者中的应用

Application of Atorvastatin combined with Probucol in Patients with coronary Heart Disease and Diabetes undergoing percutaneous coronary stent Implantation

目的探讨阿托伐他汀联合普罗布考在行经皮冠状动脉支架置入术(PCI)冠心病伴糖尿病患者中的应用。方法以解放军联勤保障部队第九八八医院2015年3月至2020年3月择期进行PCI术的230例冠心病伴糖尿病患者为研究对象进行回顾性分析,根据治疗方法不同分为联合组(76例,基础治疗上予以阿托伐他汀联合普罗布考)、阿托伐他汀组(77例,基础治疗上予以阿托伐他汀)、普罗布考组(77例,基础治疗上予以普罗布考),比较三组患者手术前后的肾功能变化[包括血清肌酐(Scr)、血尿素氮(BUN)、血清胱抑素(Cys C)]、术后急性肾损伤(CIAKI)发病情况。结果术后72 h,联合组Scr、BUN、Cys C指标均显著低于阿托伐他汀组和普罗布考组,差异均有统计学意义(P<0.05);阿托伐他汀组与普罗布考组Scr、BUN、Cys C指标比较,差异无统计学意义(P>0.05)。术后,联合组CIAKI发生率(1.32%)显著低于阿托伐他汀组(9.09%)和普罗布考组(11.69%),差异均有统计学意义(P<0.05);阿托伐他汀组与普罗布考组CIAKI发病率比较,差异无统计学意义(P>0.05)。结论阿托伐他汀联合普罗布考能有效预防冠心病伴糖尿病患者PCI术后并发CIAKI,避免肾功能损伤。

Objective To investigate the application of atorvastatin combined with probucol in patients with coronary artery disease and diabetes mellitus undergoing percutaneous coronary stent implantation(PCI).Methods A retrospective analysis was conducted on 230 patients with coronary heart disease and diabetes who underwent elective PCI from March 2015 to March 2020 in the 988 th Hospital of the PLA joint logistics support force,according to the different treatment methods they were divided into the combined group(76 cases,atorvastatin and probucol),the atorvastatin group(77 cases,atorvastatin),and the probucol group(77 cases,probucol),the changes of renal function including Serum Creatinine(Scr),blood urea nitrogen(Bun),serum cystatin C(Cys C)and postoperative acute renal injury(CIAKI)were compared between the three groups.Results At 72 hours after operation,the indexes of Scr,BUN and Cys C in the combined group were significantly lower than those in the atorvastatin group and the probucol group(P<0.05),there was no significant difference in Scr,BUN and Cys C between atorvastatin group and probucol group(P>0.05).After operation,the incidence of CIAKI in the combined group(1.32%)was significantly lower than that in the atorvastatin group(9.09%)and the probucol group(11.69%)(P<0.05),there was no significant difference in CIAKI between atorvastatin group and probucol group(P>0.05).Conclusion Atorvastatin combined with probucol can effectively prevent CIAKI and renal function damage after PCI in patients with coronary heart disease and diabetes mellitus.