阿托伐他汀强化治疗对老年肾功能不全患者PCI术后造影剂肾病的预防作用

Preventive effect of atorvastatin intensive treatment for the contrast induced nephropathy after PCI in elderly patients with renal insufficiency

目的探究阿托伐他汀强化治疗对老年肾功能不全患者经皮冠状动脉介入(PCI)术后造影剂肾病的预防作用。方法选择2017年8月至2020年7月在我院行PCI术的200例老年肾功能不全患者作为研究对象,按照抽签法将其分为观察组和对照组,各100例。观察组实施阿托伐他汀强化治疗,对照组实施阿托伐他汀常规治疗。比较两组手术前、后的肾功能指标、炎症反应指标及手术后造影剂肾病发生情况。结果手术后,两组的Scr水平均高于手术前,但观察组低于对照组(P<0.05);手术后,两组的eGFR、Ccr均低于手术前,但观察组高于对照组(P<0.05)。手术后,两组的hs-CRP、IL-6、TNF-α水平均高于手术前,但观察组低于对照组(P<0.05)。手术后,观察组的造影剂肾病发生率低于对照组(P<0.05)。结论阿托伐他汀强化治疗在老年肾功能不全患者PCI术后能改善患者的肾功能,降低炎症反应指标水平,从而降低造影剂肾病的发生风险。

Objective To explore the preventive effect of atorvastatin intensive treatment for the contrast induced nephropathy after percutaneous coronary intervention(PCI)in elderly patients with renal insufficiency.Methods A total of 200 elderly patients with renal insufficiency who underwent PCI in our hospital from August 2017 to July 2020 were selected as the research objects.The patients were divided into observation group and control group by lot,with 100 cases in each group.The observation group was given atorvastatin intensive treatments and the control group was given atorvastatin routine treatment.The renal function indexes,inflammatory reaction indexes before and after operation and the incidence of contrast induced nephropathy after operation were compared between the two groups.Results After operation,the level of Scr in the two groups was higher than that before operation,but that in the observation group was lower than the control group(P<0.05);after operation,the eGFR and Ccr in the two groups were lower than those before operation,but those in the observation group were higher than the control group(P<0.05).After operation,the levels of hs-CRP,IL-6 and TNF-α in the two groups were higher than those before operation,but those in the observation group were lower than the control group(P<0.05).After operation,the incidence of contrast induced nephropathy in the observation group was lower than that in the control group(P<0.05).Conclusion Atorvastatin intensive treatment in elderly patients with renal insufficiency after PCI can improve the renal function,reduce the levels of inflammatory reaction indexes,and thereby reduce the risk of contrast induced nephropathy.