他汀类药物对老年冠状动脉旁路移植术后急性肾损伤的影响

Protective effect of statins on acute kidney injury in elderly patients with coronary artery bypass grafting

目的观察术前常规使用他汀类药物治疗对老年冠状动脉旁路移植术(Coronary artery bypass grafting,CABG)患者急性肾损伤(acute kidney injury,AKI)的影响。方法将进行冠状动脉旁路移植术的老年患者396例,根据患者术前是否常规应用他汀类药物分为阿托伐他汀组(n=104)、瑞舒伐他汀组(n=203)和对照组(n=89)。比较3组患者手术前后尿素氮(blood urea nitrogen,BUN)、血清肌酸酐(serum creatinine,Scr)、肾小球滤过率(glomerular filtration rate,GFR)和术后急性肾损伤(AKI)发生率。结果术后,阿托伐他汀组、瑞舒伐他汀组和对照组BUN分别为(5.56±2.58),(5.14±2.30)和(8.25±5.14)mmol·L^(-1),Scr分别为(77.80±37.35),(72.93±33.80)和(98.86±62.50)mmol·L^(-1),GFR分别为(84.68±30.48),(87.58±27.52)和(66.26±27.76)mL·min^(-1),AKI发生率分别为14.42%,7.39%和31.46%,阿托伐他汀组和对照组比较,差异均有统计学意义(均P<0.05),瑞舒伐他汀组和对照组比较,差异均有统计学意义(均P<0.05)。结论老年冠状动脉旁路移植术患者,术前常规应用阿托伐他汀或瑞舒伐他汀均可以延缓肾功能的下降,降低术后AKI发生率。

Objective To evaluate the effect of routine preoperation statins therapy on acute kidney injury(AKI)after coronary artery bypass grafting(CABG)in elderly patients.Methods A total of 396 patients with CABG were enrolled and were divided into three groups according to the routine use of rosuvastatin or atorvastatin before operation:atorvastatin group(n=104),rosuvastatin group(n=203)and control group(n=89).The blood urea nitrogen(BUN),serum creatinine(Scr),glomerular filtration rate(GFR)and emergence of AKI were compared among three groups.Results After operation,the BUN in atorvastatin group,rosuvastatin group and control group were(5.56±2.58),(5.14±2.30)and(8.25±5.14)mmol·L^(-1),the Scr were(77.80±37.35),(72.93±33.80)and(98.86±62.50)mmol·L^(-1),the GFR were(84.68±30.48),(87.58±27.52)and(66.26±27.76)mL·min^(-1),respectively.The incidence of AKI were 14.42%,7.39%and 31.46%,respectively.There were significant differences between atorvastatin group and control group(all P<0.05),the re were significant differences between rosuvastatin group and control group(all P<0.05).Conclusion Preoperative conventional atorvastatin or rosuvastatin in elderly patients with CABG can protect renal function and reduce the incidence of postoperative AKI.