强化瑞舒伐他汀对冠状动脉造影检查时造影剂肾病的预防作用  

Preventive effect of high dose rosuvastatin on contrast-induced nephropathy in patient underwent coronary angiography

作　　者：刘敏[1] 闫杰[1] 张苏川[1] 杨明[1] 朱磊[1] 程波[1] 

机构地区：[1]江汉大学附属医院心血管内科,湖北武汉430015

出　　处：《川北医学院学报》2015年第3期377-380,共4页Journal of North Sichuan Medical College

基　　金：武汉市科技计划项目(200951999575)

摘　　要：目的:探讨慢性肾脏病2期的2型糖尿病患者接受冠状动脉造影检查的安全性及不同剂量瑞舒伐他汀对造影剂肾病(CIN)的预防作用。方法:选择需接受冠状动脉造影检查且肾功能处于慢性肾脏病2期的2型糖尿病患者76例。按简单随机化分组法分成两组,每组入选患者38例,普通治疗组患者接受瑞舒伐他汀10 mg、1次/晚治疗;强化治疗组患者接受瑞舒伐他汀20 mg、1次/晚治疗。所有患者冠状动脉造影术前检测血常规、肝功能、空腹血糖、糖化血红蛋白、血尿酸、血脂;术前及术后测24 h尿蛋白;检测术前24 h和术后24 h、48 h、72 h及7 d的血肌酐水平。结果:冠状动脉造影检查术后,两组患者24 h尿蛋白均较术前升高,但两组差异无统计学意义(P>0.05);术后两组患者估算的肾小球滤过率均出现一过性下降,1周后恢复至术前水平。强化治疗组患者CIN的发生率低于普通治疗组,差异有统计学意义(P<0.05)。结论:强化瑞舒伐他汀治疗对慢性肾病2期的2型糖尿病患者中是安全的,可以减少CIN的发生率。Objective：To evaluate the safety of patients with diabetes mellitus type 2 and chronic kidney disease stage 2 accepted coronary arteriography （ CAG） ,and to investigate the preventive effect of different doses of rosuvastatin on contrast-induced nephropathy （ CIN） . Methods：We enrolled 76 cases of patients with diabetes mellitus type 2 and chronic kidney disease stage 2 which needed to re-ceive CAG. All patients were divided into two groups by simple randomization. Each group enrolled 38 cases of patients. Patients of con-ventional therapy group received treatment of rosuvastatin 10 mg per night,and patients of intensive therapy group received treatment of ro-suvastatin 20 mg per night. Routine blood,liver function,fasting blood glucose,glycosylated hemoglobin A1c,serum uric acid,blood lipids were test in all the patients before CAG. 24-hour urine protein was tested before and after CAG. Renal functions of all the patients were tested 24 hours before and 24 hours,48 hours and 72 hours after CAG. Sever days after CAG,the renal function of all the patients were tested again. Results：24-hour urine protein of two groups were increased after CAG,but two groups had not significant difference （P〉0. 05）. Estimated glomerular filtration rate （eGFR） of the two groups of patients had a transient decrease and recovery to the preoperative level after 1 week. The incidence of CIN of intensive therapy group was lower than that of conventional therapy group. The incidence of two groups had significant difference （P〈0. 05）. Conclusion：Treatment of rosuvastatin 20 mg per night in patients with diabetes mellitus type 2 and chronic kidney disease stage 2 is safety and can reduce the incidence of CIN.

关 键 词：慢性肾脏病 瑞舒伐他汀 2型糖尿病 肾小球滤过率 24小时尿蛋白 造影剂肾病 冠状动脉造影 

分 类 号：R691.9[医药卫生—泌尿科学]