阿托伐他汀对冠心病患者冠状动脉造影术后超敏C反应蛋白的影响及其对肾功能的保护作用  

Beneficial effects of atorvastatin on high sensitivity C-reactive protein and renal function in patients with coronary artery disease undergone coronary angiography

作　　者：陈光铃[1] 王琛[1] 蔡文钦[2] 

机构地区：[1]福建医科大学附属闽东医院心内科,福建福安355000 [2]福建医科大学附属第一医院老年病科

出　　处：《临床心血管病杂志》2011年第5期355-358,共4页Journal of Clinical Cardiology

摘　　要：目的：研究阿托伐他汀对冠心病患者行冠状动脉造影术（CAG）后超敏C反应蛋白（hsCRP）的影响及对肾功能的保护作用。方法：将行CAG确诊的84例冠心病患者随机分为治疗组（43例）或对照组（41例）,治疗组于CAG前2~3 d始每晚顿服阿托伐他汀20 mg,对照组CAG前未服用阿托伐他汀及其他调脂类药。所有患者分别于CAG前,术后24 h、48 h测定血肌酐（Cr）及尿素氮（BUN）;留尿标本检测尿α1-微球蛋白（α1-MG）、尿转铁蛋白（TRF）、尿微量白蛋白（mALB）;测血浆胱抑素C（Cys C）、hsCRP,并分别计算出肌酐清除率（Ccr）和肾小球滤过率（GFR）。结果：①对照组：与CAG前相比,CAG后24 hα1-MG、TRF、mALB、Cys C及hsCRP均有显著升高（P〈0.01）;与CAG后24 h比较,48 hα1-MG、TRF、mALB、Cys C均有显著降低（P〈0.01）,但α1-MG、Cys C仍高于CAG前水平（P〈0.01）,而TRF、mALB已恢复到CAG前水平（P〉0.05）;CAG后48 hhsCRP与CAG前相比无明显变化（P〉0.05）。②治疗组：与CAG前比较,CAG后24 h、48 hα1-MG、TRF、mALB、Cys C均无明显变化（P〉0.05）;CAG后24 h hsCRP显著升高（P〈0.01）;CAG后48 h hsCRP与CAG前比无明显变化（P〉0.05）。③与治疗组相比较：对照组CAG后24 hα1-MG、TRF、mALB、Cys C及hsCRP均显著升高（P〈0.01）;CAG后48 h Cys C、α1-MG及hsCRP仍显著升高（P〈0.01）,但TRF、mALB均差异无统计学意义（P〉0.05）。2组CAG前、术后BUN、Cr、Ccr均无明显变化（P〉0.05）。结论：小剂量造影剂可造成冠心病患者CAG后出现hsCRP、CysC升高及一过性微量蛋白尿,CAG前2~3 d给服阿托伐他汀,具有改善的作用。Objective：To study the beneficial effects of atorvastatin on high sensitivity C-reactive protein（hs-CRP） and renal function in patients with coronary artery disease undergone coronary angiography.Method：Eighty-four patients undergone coronary angiography were prospectively entrolled and randomized to receive atorvastatin（20 mg/qn,n=43） or no atorvastatin（n=41） treatment for 2 to 3 days before coronary angiography.Urinary α1-MG,TRF and mALB were detected to evaluate the tubular or glomerular damage immediately,24 hours and 48 hours after the administration of a radiocontrast agent.Serum creatinine,BUN,cystatin C and hsCRP levels were also assessed at the same time.Ccr and GFR were calculated ccording to Cockcroft-Gault or GFR（ml/min）=74.835/CysC1.33 formulas based on serum creatinine or cystatin C concentration.Result：①In control group,compared with the levels before coronary angiography,urinary α1-MG,TRF and mALB or serum cystatin C and hsCRP increased significantly on day 1 after angiography（P0.01）.In comparison to the day 1 levels taken after angiography,urinary α1-MG,TRF,mALB,serum cystatin C significantly decreased on day 2 after angiography（P0.01）,but α1-MG,cystatin C still exceeded the levels before coronary angiography.TRF and mALB levels on day 2 after angiography had no significant changes compared to the baseline（P0.05）,and hsCRP levels on day 2 after angiography had no significant changes compared to the day 1 levels after angiography（P0.05） either.②In comparison with the levels before coronary angiography in atorvastatin treated group,urinary α1-MG,TRF and mALB or serum cystatin C levels on day 1 after angiography had no significant changes compared to the baseline（P0.05）,and the same results were also found on day 2.HsCRP increased significantly on day 1 after angiography compared to the baseline（P0.01）,but it had no significant changes compared that on day 2 after angiography（P0.05）.③Compared to the atorvastatin-treated group,the levels of

关 键 词：阿托伐他汀 造影剂 超敏C反应蛋白 肾功能 

分 类 号：R972[医药卫生—药品]