阿托伐他汀强化治疗对冠心病介入治疗术后肾功能的影响  

Effect of atorvastatin intensive treatment on kidney function in patients with coronary heart disease after percutaneoustransluminal coronary intervention therapy

作　　者：陈锐[1] 阮长武[1] 王占成[1] 李志善[2] 沈艳[1] 袁柳[1] 

机构地区：[1]上海市第八人民医院心内科,上海200235 [2]复旦大学附属中山医院心内科,上海200032

出　　处：《中国临床药学杂志》2011年第2期82-85,共4页Chinese Journal of Clinical Pharmacy

摘　　要：目的观察阿托伐他汀强化治疗能否减少造影剂对肾功能的影响和减少对比剂肾病(CIN)的发病率。方法选取行冠心病介入治疗(PCI)术患者80名,随机分为强化治疗组(给予阿托伐他汀40 mg·d^(-1))和常规治疗组即对照组(阿托伐他汀20mg·d^(-1)),观察2组患者(PCI)术前术后肾功能情况并作统计学处理。结果 80例患者发生CIN 15例,其中治疗组5例(12.5%),对照组10例(25%)。治疗组术后各项指标与术前比较差异无统计学意义,对照组术后尿素氮、肌酐、肌酐清除率、肾小球滤过率与术前比较差异均有统计学意义(P<0.05)。结论阿托伐他汀强化治疗有着心血管保护作用之外的肾脏保护作用,对于拟行PCI术的冠心病患者合并肾功能异常时,术前1周给予阿托伐他汀强化治疗,术后给予充分的水化治疗,可减少CIN的发病率及减少造影剂对肾功能的损害。AIM To observe whether atorvastatin treatment in patients of coronary heart disease（CHD） can decrease the effect of constrastmedium on kidney function and the incidence of contrast-media induced nephropathy（CIN）. METHODS Eighty patients with percutaneoustransluminal coronary intervention（PCI） were selected and divided into 2 groups.Groupl was enhanced treatment group（every patient was given 40 mg atorvastatin every day）.Group2 was traditional treatment group（every patient was given 20 mg atorvastatin every day）.RESULTS Fifteen patients had CIN,among which,five belonged to group1,and ten belonged to group 2.Compared with those before PCI,there wasn＇ t statistical difference on all kidney function after PCI in group 1.In group 2,the statistical difference of BUN,Cr,Ccr and glomerular filtration rate was significantly remarkable（P0.05） as compared with those before PCI.CONCLUSION In addition to cardiovascular protection,atorvastatin can also be used to protect the kidney in CHD patients.The CHD patients with abnormal renal function prepared for PCI,given intensive atorvastatin treatment one week before PCI and sufficient hydrating treatment after PCI,the incidence of CIN and the damage of contrast medium on renal function can be decreased.

关 键 词：阿托伐他汀 冠心病介入治疗 肾功能 

分 类 号：R541.4[医药卫生—心血管疾病]