强化他汀类药物治疗预防造影剂肾病的对比研究  

A comparative study of intensive statins in the prevention of contrast-induced nephropathy

作　　者：陆锐[1] 邓可武[2] 张文超[1] 姚民 

机构地区：[1]北京市第六医院心内科,100007 [2]首都医科大学附属北京同仁医院心内科二病区,100730 [3]中国医学科学院阜外医院五十病区,100037

出　　处：《中国医药》2016年第7期1043-1046,共4页China Medicine

摘　　要：目的探讨强化他汀类药物治疗对经皮冠状动脉介入术后造影剂肾病（CIN）的预防作用。方法选取2013年7月至2015年7月在北京市第六医院、首都医科大学附属北京同仁医院和中国医学科学院阜外医院择期行冠状动脉介入治疗患者925例，依据他汀类药物使用情况分为阿托伐他汀强化治疗组（540例）、瑞舒伐他汀强化治疗组（200例）和对照组（185例）。阿托伐他汀强化治疗组于术前1天给予阿托伐他汀钙片40mg，每晚1次，术后减至20mg／d并坚持服用1年；瑞舒伐他汀强化治疗组术前1天给予瑞舒伐他汀20mg负荷量，术后减至10mg／d并服用1年；对照组术前服用任何一种常规治疗量他汀药物。比较3组患者CIN发生率和手术前后血肌酐水平。结果阿托伐他汀强化治疗组、瑞舒伐他汀强化治疗组和对照组CIN发生率分别为8．3％（45／540）、9．0％（18／200）和9．2％（17／185）；3组CIN发生率比较，差异均无统计学意义（F=7．67，P=0．45）。3组手术前后血肌酐水平比较，差异均无统计学意义（均P〉0．05）。结论强化他汀治疗未能降低CIN发生率。Objective To investigate the preventive effect of intensive statins on contrast-induced nephropathy（CIN） after percutaneous coronary intervention （PCI）. Methods Totally 925 patients who had PCI therapy from July 2013 to July 2015 in Beijing NO. 6 Hospital, Beijing Tongren Hospital, Capital Medical Univer- sity and Fuwai Hospital, Chinese Academy of Medical Sciences were enrolled and divided in to 2 groups according to the use of statins ： intensive atorvastatin group （54 cases）, intensive rosuvastatin group （ 200 cases） and control group（ 185 cases）. The intensive atorvastatin group was treated with atorvastatin 40 mg at bedtime 1 day before operation and 20 rag/d, 1 time/d, at bedtime after operation for 1 year; the intensive rosuvastatin group was trea- ted with rosuvastatin 20 mg 1 day before operation and 10 mg/d after operation for 1 year; the control group was treated with routine statins medicine before operation. Incidences of CIN, serum levels of creatinine before and af- ter operation were analyzed between groups. Results Incidences of CIN in intensive atorvastatin group, intensive rosuvastatin group and control group were respeetively 8.3% （45/540）, 9.0% （ 18/200 ） and 9.2% （ 17/185 ）, there was no significant difference of incidences of CIN among 3 groups （ F = 7.67, P = 0.45 ） ; and there was no signifieant differenee of preoperative and postoperative serum ereatinine levels among groups （ P 〉 0. 05 ）. Conclusion Intensive statins therapy can not reduce the incidence of CIN.

关 键 词：造影剂肾病 强化他汀 经皮冠状动脉介入 

分 类 号：R692[医药卫生—泌尿科学]