强化阿托伐他汀对老年冠心病合并肾功能不全患者介入治疗后造影剂肾病的预防作用

The preventive effect of contrast induced nephropathy in elderly coronary heart disease patients with renal insufficiency after percutaneous coronary intervention treated by atorvastatin

Objective To investigate the preventive effect of contrast induced nephropathy （CIN） in elderly patients of coronary heart disease with renal insufficiency after percutaneous coronary intervention （PCI） treated by atorvastatin. Methods 300 elderly coronary heart disease patients with renal insufficiency accepted PCI in Tianjin Chest Hospital were randomly divid-ed into conventional treatment group（n=150） and intensive treatment group（n=150）.Patients in the two groups were given ator-vastatin 10mg and 40mg respectively before PCI and 72h after PCI. The level of blood urea nitrogen （BUN）， serum creatinine （Scr）， creatinine clearance rate （Ccr）， interleukin-6（IL-6），β2-microglobulin（β2-MG）， C-reactive protein（CRP）， alanine aminotransferase （ALT） were measured at admission and 72h after the procedure. Results 1The incidence of CIN in the in-tensive treatment group was 2.7%； the incidence of CIN in the conventional treatment group was 8.7%（χ2=5.05，P<0.05）.2There was no statistical difference in the levels of BUN， Scr， Ccr， IL-6，β2-MG， CRP before PCI （P>0.05）. The level of β2-MG， CRP and IL-672h after PCI was higher than before PCI （P<0.05）.372h after the procedure， the level of IL-6，β2-MG， CRP were lower in intensive treatment group than the conventional treatment group， and the level of Ccr was higher in intensive treatment group. Conclusion The administration of intensive atorvastatin before PCI has good preventive effect in elderly coronary heart disease patients with renal insufficiency. The protection mechanism may have relationship with the anti-inflamma-tion effect.