阿托伐他汀对脓毒症患者急性肾损伤的保护作用  

Protective effect of Atorvastatin on renal function in patients with sepsis

作　　者：舒平[1] 周慧云[1] 黄志刚[1] 何燕[1] 

机构地区：[1]北京大学深圳医院急诊科,深圳518036

出　　处：《中华危重症医学杂志（电子版）》2013年第2期5-9,共5页Chinese Journal of Critical Care Medicine:Electronic Edition

摘　　要：目的探讨阿托伐他汀对脓毒症患者肾功能的保护作用。方法选取脓毒症患者共112例,随机分为A组(56例)和B组(56例,其中3例失访),A组按脓毒症指南常规综合治疗,B组另外加用阿托伐他汀治疗。分别在入院第1、3、7天取患者血液标本,检测其血清肌酐、胱抑素C、丙氨酸转氨酶(ALT)和C反应蛋白(CRP),同时记录其急性病生理学和长期健康评价(APACHE)Ⅱ评分。结果 B组患者在第7天时血肌酐及胱抑素C均较A组低(t=2.186、2.120,P=0.031、0.036),而血CRP在第3、7天明显低于A组(t=2.127、3.208,P=0.035、0.002),APACHEⅡ评分在第7天亦较A组低(t=2.083,P=0.042)。两组患者的血清ALT比较,差异无统计学意义。结论阿托伐他汀能减轻脓毒症所致急性肾损伤,从而改善患者病情。Objective To investigate the protective effect of Atorvastatin on renal function in patients with sepsis. Methods One hundred and twelve patients with sepsis were randomly divided into group A （56 cases） and group B （56 cases）. In group B, 3 patients lost to follow up. Patients in group A served as control were treated according to international guidelines for sepsis, while cases in group B were treated with Atorvastatin （20 mg / d） in addition. Blood samples of all the cases were collected on admission, day 3, and day 7. Serum creatinine （sCr）, cystatin C, alanine aminotransferase （ALT） and C reactive protein （CRP） levels were examined, acute physiology and chronic health evaluation （APACHE）H scores were also evaluated simultaneously with blood sampling. Results On day 7 after admission, the sCr, cystatin C levels of patients in group B were significantly lower than those in group A （t = 2.186, 2.120, P= 0.031, 0.036）, and the APACHE l] scores were reduced more obviously in group B compared with that in group A （t = 2.083, P = 0.042）, while CRP levels of group B on days 3, 7 were both remarkably lower than that of group A（t = 2.127, 3.208, P= 0.035, 0.002）. There was no statistical significance in serum ALT between the two groups. Conclusion Atorvastatin can reduce the sepsis-induced acute kidney injury, thus to improve the clinical condition of patients with sepsis.

关 键 词：脓毒症 急性肾损伤 阿托伐他汀 急性病生理学和长期健康评价 

分 类 号：R459.7[医药卫生—急诊医学]