阿托伐他汀联合普罗布考降低冠状动脉性心脏病介入治疗围手术期血尿酸水平  

Combined treatment with atorvastatin and probucol can reduce perioperative serum uric acid level in patients undergoing percutaneous coronary intervention

作　　者：李作成[1] 马洪俊[2] 王一然[1] 李曦铭[1] 胡越成[1] 肖建勇[1] 赵茹[1] 金冬霞[1] 付乃宽[1] 丛洪良[1] 

机构地区：[1]天津市胸科医院心内科,天津300051 [2]天津市大港油田总医院心血管一科

出　　处：《中华高血压杂志》2013年第3期260-264,共5页Chinese Journal of Hypertension

基　　金：天津市科技计划重点项目(12ZCZDSY03200);天津市卫生局科技重点攻关项目(10KG122;12KG127);天津市卫生局科技基金(2011KZ64)

摘　　要：目的观察介入治疗术前联用不同剂量的阿托伐他汀和普罗布考对围手术期血尿酸水平的影响。方法入选接受择期冠状动脉造影(CAG)或经皮冠状动脉介入治疗(PCI)的冠状动脉性心脏病(冠心病)患者208例,随机分为3组:①标准剂量联合治疗组(n=55):阿托伐他汀每晚顿服20mg,普罗布考250mg,2次/d,术前无强化;②强化剂量联合治疗组(n=79):阿托伐他汀每晚顿服40mg,普罗布考500mg,2次/d,术前2h顿服阿托伐他汀40mg,普罗布考500mg;③强化剂量治疗组(n=74):阿托伐他汀每晚顿服40mg,术前2h顿服阿托伐他汀40mg。所有患者均于术前、术后24h抽取静脉血检测尿素氮、肌酐、尿酸,估算的肾小球滤过率(eGFR)。结果与术前比较,3组术后血尿素氮均下降。标准剂量联合组及强化剂量组术后血肌酐升高(P<0.05),强化剂量联合组术后肌酐无明显变化(P>0.05)。标准剂量联合组及强化剂量联合组术后尿酸下降[标准剂量联合组:术后(299.32±72.16)比术前(322.36±77.57),强化剂量联合组:(281.20±62.80)比(310.45±69.59)μmol/L,P<0.05],而强化剂量组尿酸无明显变化(P>0.05)。高血压亚组,标准剂量联合组和强化剂量组术后血肌酐升高,eGFR下降[(74.67±14.36)比(79.68±13.14);(73.75±14.80)比(77.87±14.91)mL/(min·1.73m2),P<0.05];强化剂量联合组术后血尿酸下降[(285.05±66.12)比(314.88±70.97)μmol/L,P<0.05]。结论介入术前联用阿托伐他汀和普罗布考可以降低围手术期血尿酸水平。Objective To observe the combined effects of different doses of atorvastatin and probucol on periopera- tire serum uric acid level in patients undergoing percutaneous coronary intervention （PCI）. Methods Two hundred and eight patients undergoing selective coronary artery angiography or percutaneously coronary intervention for coro- nary heart disease were enrolled and randomly divided into three groups：standard dose combind treatment group（tak- ing atorvastatin 20 mg qn and probucol 0.25 g bid, n= 55）, intensive dose combind treatment group（taking atorvas- tatin 40 mg qn and probucol 0.5 g bid,and taking a further dose of atorvastatin 40 mg and probueol 0.5 g two hours before the operation; n~ 79 }, and intensive dose treatment group（taking atorvastatin 40 mg qn,and taking a futher dose of atorvastatin 40 mg two hours before the operation; n= 74}. Twenty-four hours before and after the proce- dure,the level of blood urea nitrogen（BUN）, serum creatinine （Scr） and serum uric acid（SUA） of all patients were detected and glomerular filtration rate （eGFR） was calculated through the formula of MDRD. Results Compared with those before the operation, BUN of all groups decreased. In standard dose combind treatment group and intensive dose treatment group, the level of Scr significantly increased after the operation（P〈0.05）, while there was no significant difference in intensive dose combind treatment group （P〈0. 05）. In standard dose combind treatment group and intensive dose combind treatment group, SUA decreased after the operation [（299.32 ±72. 16） vs （322.36±77.57）, （281.20±62.80） vs （310.45±69.59）pmol/L; P〈0. 05], while there was no significant change in the SUA of intensive treatment group （P〈0. 05）. In hypertensive patients, Scr increased and eGFR decreased [（74.67±14.36） vs （79. 682±13.14） ; （73.75±14.80） vs （77. 87±14.91）mL/（min ·1.73 m2 ）, P〈0.05] after the operation in standard dose combind treatment group and intens

关 键 词：阿托伐他汀 普罗布考 血尿酸 对比剂急性肾损伤 介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]