阿托伐他汀预防冠脉CTA检查对比剂肾病的临床研究  

Clinical Research of Atorvastatin on Preventing Contrast-Induced Nephropathy in Patients Underwent Coronary Artery CTA

作　　者：林娟[1] 洪鹭蓉[1] 邱艳[1] 谢玉华[1] 方勇强[1] 柯瑟章[1] 

机构地区：[1]福建医科大学附属漳州市医院干部病房科,福建漳州363000

出　　处：《临床医学工程》2010年第12期48-50,共3页Clinical Medicine & Engineering

摘　　要：目的研究不同剂量阿托伐他汀在预防对比剂肾病中的作用。方法将92例单纯行冠脉CTA检查的患者随机分为大剂量组(40mg/d,n=46)和小剂量组(10mg/d,n=46),分别于冠脉CTA检查前2～3天开始每晚顿服阿托伐他汀40mg及10mg。所有患者分别于冠脉CTA检查前1天、检查后第1天、第3天、第7天测定尿素氮(BUN)及血肌酐(Scr),留尿标本检测尿微量白蛋白(mALB),并根据Cockcroft-Gault公式计算出内生肌酐清除率(Ccr)。结果①小剂量组:与检查前相比,检查后第1、3天Scr、mALB均有显著升高(P<0.01),Ccr显著降低(P<0.01);检查后第7天Scr、Ccr、mALB均无显著性变化(P>0.05)。②大剂量组:与检查前比较,检查后第1、3天Scr、mALB均升高(P<0.05),Ccr降低(P<0.05),检查后第7天Scr、Ccr、mALB均无显著性变化(P>0.05)。③与小剂量组相比:大剂量组检查后第1、3天Scr、mALB显著降低(P<0.01),Ccr显著升高(P<0.01);检查后第7天mALB、Scr、Ccr均无统计学差异(P>0.05)。两组检查前后BUN均无明显的变化(P>0.05)。结论使用较大剂量(40mg)的阿托伐他汀可能有助于预防对比剂肾病的发生。Objective To investigate the effect of different doses of atorvastatin on preventing contrast-induced nephropathy（CIN） . Methods 92 patients who underwent coronary artery angiography with 64-slice spiral computed tomography were randomized to receive high dose of atorvastatin（40 mg/d,n=46） or small dose of atorvastatin（10 mg/d,n=46） treatment for 2 ～ 3 days before coronary artery angiography with 64-slice spiral computed tomography. Urinary mALB was checked for evidence of tubular or glomerular damage at start,1 day,3 days and 7 days after the administration of a radiocontrast agent. Serum creatinine and BUN were also assessed at the same time. Ccr was calculated according to Cockcroft-Gault formula. Results ①In control group,comparison with the value before coronary artery angiography with 64-slice spiral computed tomography,Scr and mALB significantly increased（P 0.01） ,but Ccr significantly reduced at day 1 and day 3 after angiography（P 0.01） . Scr,Ccr and mALB levels at day 7 after angiography had no significant change compared to baseline（P 0.05） . ②In the test group,comparison with the value before coronary artery angiography with 64-slice spiral computed tomography,Scr and mALB significantly increased（P 0.05） and Ccr reduced at day 1 and day 3 after angiography（P 0.05） . Scr,Ccr and mALB levels at day 7 after angiography had no significant change compared to baseline（P 0.05） . ③Compared to the control group,the values of Scr and mALB significantly reduced（P 0.01） ,but Ccr significantly increased at day 1 and day 3 after angiography in atorvastatin-treated group（P 0.01） . Scr,Ccr and mALB levels at day 7 after angiography had no significant change compared to baseline（P 0.05） . There was no significant change in BUN levels compared to baseline after angiography in two groups（P 0.05） . Conclusion Taking high dose of atorvastatin before angiography with contrast media maybe prevent the contrast-induced nephropathy.

关 键 词：阿托伐他汀 对比剂肾病 冠脉CTA 

分 类 号：R541.4[医药卫生—心血管疾病] R692.9[医药卫生—内科学]