瑞舒伐他汀联合红花黄色素防治冠状动脉介入诊疗术后对比剂肾病的临床观察  

Clinical Observation of Rosuvastatin Combined with Safflower Yellow in the Prevention and Treatment of Contrast-induced Nephropathy in Patients Undergoing Angiography and Percutaneous Coronary Intervention

作　　者：吴鑫 李文华 田玉龙 Wu Xin;Li Wenhua;Tian Yulong(Department of Graduate School of Xuzhou Medical University,Jiangsu 221004,China)

机构地区：[1]徐州医科大学研究生学院,221004 [2]徐州医科大学附属医院心血管内科,221004 [3]盱眙县人民医院,211700

出　　处：《医学研究杂志》2020年第1期137-140,144,共5页Journal of Medical Research

摘　　要：目的观察瑞舒伐他汀(rosuvastatin)联合红花黄色素(safflower yellow,SY)对冠心病患者行冠状动脉介入诊疗术后对比剂肾病(contrast-induced nephropathy,CIN)的临床疗效。方法选取2018年1月~2019年3月在江苏省盱眙县人民医院拟行冠状动脉造影术(coronary angiography,CAG)或经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)的202例患者作为研究对象,剔除2例(其中1例患者严重三支病变影响手术时间,另1例患者LAD慢性闭塞性病变影响手术时间),按照随机数字表法将剩余200例患者分成空白组(n=48)、瑞舒伐他汀组(n=52)、红花黄色素组(n=49)及联合用药组(瑞舒伐他汀+红花黄色素组,n=51)。其中,空白组给予标准水化治疗,瑞舒伐他汀组在空白组基础上加用瑞舒伐他汀(术前48h内口服瑞舒伐他汀10mg/d,至术后第3~5天),红花黄色素组在空白组的基础上加用红花黄色素氯化钠注射液(术前48h内静脉滴注红花黄色素氯化钠注射液100ml/d,至术后第3~5天),联合治疗组则在空白组的基础上给予瑞舒伐他汀联合红花黄色素氯化钠注射液的治疗方案,剂量同上。观察4组患者术前、术后72h内的血肌酐(Scr)、尿素氮(BUN)、血清肌酐清除率(Ccr),记录并比较4组患者血肌酐的变化值(ΔScr)、血清肌酐清除率的变化值(ΔCcr)、血肌酐的变化率(ΔScr%)及CIN发生率。结果4组患者术前Scr、BUN、Ccr比较,差异无统计学意义(P>0.05);瑞舒伐他汀组和红花黄色素组的ΔScr、ΔScr%均低于空白组,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);联合治疗组的ΔScr、ΔScr%均低于瑞舒伐他汀组和红花黄色素组,差异有统计学意义(P<0.05)。瑞舒伐他汀组和红花黄色素组的ΔCcr均高于空白组,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);联合治疗组术后ΔCcr高于瑞舒伐他汀组和红花黄色素组,差异有统计学意义(P<0.05)。Objective To observe the clinical efficacy of rosuvastatin combined with safflower yellow in the treatment of contrast-induced nephropathy(CIN)after coronary intervention.Methods A total of 202 patients who were scheduled to undergo coronary angiography(CAG)or percutaneous coronary intervention(PCI)in Jiangsu Xuyi People′s Hospital from January 2018 to March 2019 were selected as the study subjects.Two patients(one with severe three-vessel disease affecting the operation time,and the other with chronic occlusive disease of LAD affecting the operation time)were excluded.The remaining 200 patients were divided into control group(n=48),rosuvastatin group(n=52),safflower yellow group(n=49)and combination therapy group(rosuvastatin+safflower yellow group,n=51)according to the random number table.The control group was given standard hydration therapy,the rosuvastatin group was added with rosuvastatin on the basis of control group(rosuvastatin 10mg/d was orally administered within 48 hours before operation until 3-5days after operation),the safflower yellow group was added with safflower yellow and sodium chloride injection(safflower yellow and sodium chloride injection 100ml/d was intravenously infused within 48 hours before operation until 3-5days after operation)on the basis of control group,and the combination group was given the treatment regimen of rosuvastatin combined with safflower yellow and sodium chloride injection on the basis of control group,with the same dose as above.The serum creatinine(Scr),urea nitrogen(BUN)and serum creatinine clearance(Ccr)were observed before and within 72 hours after operation in the four groups.The changes of serum creatinine(ΔScr),serum creatinine clearance(ΔCcr),serum creatinine change rate(ΔScr%)and incidence of CIN were recorded and compared between the four groups.Results There was no significant difference in preoperative Scr,BUN and Ccr between the four groups(P>0.05).ΔScr andΔScr%in rosuvastatin group and safflower yellow group were lower than those in control gro

关 键 词：瑞舒伐他汀 红花黄色素 冠心病 对比剂肾病 

分 类 号：R5[医药卫生—内科学]