短期高强度阿托伐他汀预防急性脑梗死合并糖尿病患者介入诊疗后对比剂肾病的有效性  

Efficacy of short-term and intensive atorvastatin in the prevention of contrast-induced nephropathy in patients with acute cerebral infarction complicated with diabetes mellitus after interventional treatment

作　　者：朱斐斐[1] 马红岗[2] 汪荣华[1] 刘波[3] ZHU Feifei;MA Honggang;WANG Ronghua;LIU Bo(Department of PharmacyHuzhou 313000,China;Department of Neurolo-gy,Huzhou 313000,China;Department of Nephrology,Zhejiang Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院药剂科,湖州313000 [2]浙江省湖州市中心医院神经内科,湖州313000 [3]浙江省湖州市中心医院肾内科,湖州313000

出　　处：《中国临床药学杂志》2018年第6期397-400,共4页Chinese Journal of Clinical Pharmacy

基　　金：湖州市科学技术局项目(编号2014GYB36)

摘　　要：目的研究短期、高强度阿托伐他汀对预防急性脑梗死合并糖尿病患者发生介入诊疗后对比剂肾病(CIN)的有效性。方法选择2015年1月至2017年1月在本院行脑血管介入诊断或治疗的急性脑梗死合并糖尿病患者148例,随机分成对照组71例(阿托伐他汀片20 mg+常规水化)和试验组77例(阿托伐他汀片80 mg+常规水化)。检测2组术前和术后24、48、72 h和7 d血清肌酐(SCr)、尿素氮(BUN)、胱抑素C、血清β2微球蛋白水平,并计算肾小球滤过率(e GFR)。比较2组CIN发生率及检测指标变化。结果试验组和对照组CIN发生率分别为14. 3%和29. 6%;对照组术后72 h血清SCr、BUN、胱抑素C、血清β2微球蛋白升高,与术前及同时期试验组之间差异有统计学意义(P <0. 05)。结论在常规水化基础上短期、高强度阿托伐他汀治疗,能够有效降低急性脑梗死合并糖尿病患者介入诊疗后CIN的发生率。AIM To study the efficacy of short-term and intensity atorvastatin in the prevention of contrast-induced nephropathy ( CIN) in patients with acute cerebral infarction complicated with diabetes mellitus after inter-ventional treatment. METHODS The 148 patients admitted from January 2015 to January 2017 were collected,who were diagnosed with acute cerebral infarction complicated with diabetes mellitus and afterwards under cerebralangiography. The involved patients were randomly allocated into 2 groups,71 patients of control group ( atorvastatin20 mg and conventional hydration) and 77 patients of test group ( atorvastatin 80 mg and conventional hydration) .The levels of serum SCr,BUN,cystatin C,serum beta 2 microglobulinin and serum glomerular filtration rate ( eG-FR) were monitored before and after 24 h,48 h,72 h and 7 d operation in 2 groups. The change of detection in-dex and incidence of CIN were compared between 2 groups. RESULTS The incidence rate of CIN on the statisti-cal basis of the test group and the control group were 14.3% and 29.6% respectively. Levels of SCr,BUN,cystatinC and serum beta 2 microglobulinin tested in the patients of control group after 72 h elevated with significant differ-ence ( P <0.05) ,compared to the counterparts in the test group. CONCLUSION Extra therapy of short-term andintensive atorvastatin adding to the routine of hydration before cerabral angiography may reduce the incidence rate ofcontrast-induced nephropathy in patients with acute cerebral infarction complicated with diabetes mellitus.

关 键 词：高强度治疗 阿托伐他汀 脑梗死 糖尿病 对比剂肾病 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R587.1[医药卫生—临床医学]