不同剂量阿托伐他汀对急性冠脉综合征介入术后肾功能影响  

Effect of Different Doses Atorvastatin Therapy on Renal Function for Acute Coronary Syndrome with PCI

作　　者：杨东伟[1] 刘新叶[1] 池豪[1] 程勇[1] 赵智琛[1] 

机构地区：[1]郑州大学附属郑州中心医院心内科,河南郑州450007

出　　处：《医学信息》2013年第3期44-45,共2页Journal of Medical Information

摘　　要：目的研究不同剂量阿托伐他汀治疗对急性冠状动脉综合征（ACS）患者经皮冠状动脉介入术（PCI）后肾功能的影响。方法64例PCI患者，采取随机单盲法分为常规组及强化组。常规组（32例）：服用阿托伐他汀钙片20mg／d；强化组（32例）服用阿托伐他汀钙片60mg／d；分别于术前及术后1、3、5d测定hs-CRP水平、血胱抑素（CysC）、血清肌酐（Scr）、并估测肾小球滤过率（GFR），同时分析两组患者造影剂肾病（CIN）的发病率。结果hs-CRP水平各组术后第3d水平均有显著升高，但强化组较常规组有显著降低（P〈0．05）；两组Scr水平术后第3d均升高但与术前比较无显著差异（P〉0．05）；两组术后第1dCysC水平显著高于术前，强化组较常规组显著降低（P〈0．05）；两组CIN发生率无显著差异（常规组4／32Vs强化组3／32）。结论PCI围手术期高剂量阿托伐他汀治疗可能降低造影剂导致的肾脏功能损伤；CysC在造影剂肾病的早期监测中可能具有一定的临床意义。Objective To study the effect of different doses atorvastatin therapy on renal tunction in AC5 patients with PCI . Methods34 cases ot PCI patients, randomized divided into routine and strengthen group. The routine group （32cases）： atorvastatin 20mg/d and strengthen group （32 cases ） atorvastatin 60 mg/d respectively; Hs-CRP levels, Cystatin C （ Cys C ）, serum creatinine （ Scr ）, and the estimated glomerular filtration rate （ GFR ） were determined before and after operation 1, 3, 5 day, and analysis of contrast-induced nephropathy （ CIN ） incidence. Results The level of hs-CRP in each group has increased significantly on third day after PCI, but level of strengthen group decreased significantly than that of routine group （ P 〈 0.05 ）, Scr level of two groups were increased on third day after operation but no significant difference compared with before operation （ P 〉 0.05 ）; Cys C level after PCI was significantly higher than that of baseline and strengthen group decreased significantly than routine group （ P 〈 0.05 ）.The occurrence of contrast-induced nephropathy has no significant difference （4/32 VS 3/32 ）. Conclusion High dose of atorvastatin may reduce the renal function injury by contrast agent on patients with PCI and Cys C may has clinical significance monitoring CIN in early stage.

关 键 词：急性冠状动脉综合征 经皮冠状动脉介入术 造影剂肾病 阿托伐他汀 

分 类 号：R972.6[医药卫生—药品]