超敏C蛋白对冠脉造影阴性患者术后短期肾功能的影响及阿托伐他汀干预作用  

Postoperative Renal Function Damage in Coronary Angiography Negative Patients with Preoperative High Sensitivity C-Reactive Protein and the Effects of Atorvastatin Intervention

作　　者：蔡文钦[1] 苏津自[1] 姚月娴[2,3] 谢良地[1] 杨月榕[2,3] 陈秀平[1] 王芳兵[1] 

机构地区：[1]福建医科大学附属第一医院心内科福建省高血压研究所,福建福州350005 [2]福建省立医院北院 [3]福建省老年医院心内科,福建福州350005

出　　处：《中国医学影像学杂志》2011年第7期481-485,共5页Chinese Journal of Medical Imaging

基　　金：福建省自然科学基金赞助(批准号:2010J01150)

摘　　要：目的探讨冠脉造影阴性患者术前高超敏C蛋白(hs-CRP)对术后肾功能的影响及阿托伐他汀的干预作用。材料与方法收集56例阴性患者术前、术后第1天、第2天血肌酐(Scr)、尿素氮(BUN)、尿α1-微球蛋白(α1-MG)、尿转铁蛋白(TRF)、尿微量白蛋白(mALB)及血浆胱抑素C(CysC)、hs-CRP资料,根据血肌酐计算肌酐清除率(Ccr)和CysC计算肾小球滤过率(GFR)。分组:根据术前hs-CRP水平分为hs-CRP升高组(hs-CRP≥3mg/L,n=18)和hs-CRP正常组(hs-CRP<3mg/L,n=38),根据术前是否给予阿托伐他汀分为治疗组(n=32)及对照组(n=24)。结果与术前相比,hs-CRP升高组及hs-CRP正常组术后CysC、mALB上升而GFR降低(P<0.05);与hs-CRP正常组相比,hs-CRP升高组术后CysC、mALB上升而GFR降低更为显著(P<0.05);与对照组相比较,阿托伐他汀治疗组术后第1天及第2天hs-CRP升高幅度较低,但差异无统计学意义(P>0.05)。结论对比剂对冠脉造影阴性患者具有肾损害,特别是术前hs-CRP升高患者,术前给予阿托伐他汀能减轻术后炎性反应。Purpose To investigate the postoperative renal function damage in coronary angiography negative patients with preoperative high-sensitivity C-reactive protein（hs-CRP）and the effects of atorvastatin intervention.Materials and Methods Serum creatinine（Scr）,blood urea nitrogen（BUN）,urinary α1-microglobulin（α1-MG）,urinary transferrin（TRF）,urinary microalbumin（mALB） and plasma cystatin C（Cys C）,hs-CRP were measured before（as baseline） and after coronary angiography in 56 coronary angiography negative patients.Ccr and GFR were calculated according to Scr and Cys C.Based on preoperative hs-CRP level,patients were divided into hs-CRP high group（hs-CRP≥3mg/L,n =18） and hs-CRP normal group（hs-CRP 〈3mg/L,n =38）.Thirty-two patients were treated with atorvastatin before coronary angiography（treatment group） and patients without atovastatin pretreatment were in control group（n =24）.Results Compared with the baseline,Cys C and mALB significantly increased and GFR significantly decreased on day 1 after coronary angiography in both hs-CRP high group and hs-CRP normal group（P 〈0.05）.Compared with the hs-CRP normal group,Cys C,mALB increased and GFR decreased more significantly in hs-CRP high group（P 〈 0.05）.Atovastatin treatment group had lower levels of hs-CRP on the first and second day after coronary angiography,but the difference was not statistically significant（P 〉 0.05）.Conclusion Contrast medium may induce renal function damage in coronary angiography negative patients,especially in patients with elevated hs-CRP.Pretreatment with atorvastatin may reduce inflammation after coronary angiography.

关 键 词：冠状血管造影术 阿托伐他汀 肾功能试验 超敏C反应蛋白 

分 类 号：R541.404[医药卫生—心血管疾病]