大剂量阿托伐他汀对对比剂肾病的预防作用

目的:观察大剂量阿托伐他汀对冠状动脉介入诊断及治疗致对比剂肾病的预防作用。方法:212例冠状动脉介入诊断与治疗患者随机分为大剂量阿托伐他汀组(116例)和对照组(96例),所有患者均采用水化治疗,在此基础上大剂量阿托伐他汀组患者于冠状动脉造影术前3d开始每晚顿服阿托伐他汀40mg,对照组服用阿托伐他汀20mg或其他调脂类药。分别检测两组患者术前、术后48-72h的血肌酐(Scr)和内生肌酐清除率(Ccr)。结果:大剂量阿托伐他汀组、对照组患者术后48-72h的Scr明显高于术前、Ccr明显低于术前(P<0.05),两组患者术后Scr和Ccr比较差异无统计学意义(P>0.05)。大剂量阿伐他汀组对比剂肾病发生率为1.72%(2/116),明显低于对照组的8.33%(8/96P,<0.05)。结论:术前3d以上使用大剂量阿托伐他汀,可预防冠状动脉介入诊断及治疗致对比剂肾病的发生。

PREVENTIVE EFFECTS OF LARGE DOSE ATORVASTATIN ON CONTRAST INDUCED NEPHROPATHY

Objective:To study the preventive effects of large dose atorvastatin on contrast induced nephropathy(CIN) in patients undergoing coronary artery intervention diagnosis and treatment.Methods:212 coronary artery intervention diagnosis and treatment patients were randomly divided into large dose atorvastatin group(n=116) and control group(n=96).All the patients received hydrated therapy;Moreover,patients in large dose atorvastatin group took 40mg atorvastatin 3 days before operation(one time every night),while patients in control group took 20mg atorvastatin or other lipid regulating drugs.The serum creatinine(Scr) and endogenous creatinine clearance rate(Ccr) were respectively detected before and 24-72h after operation.Results:Scr after operation of patients in 2 groups was obviously higher than that before operation,Ccr was lower than that before operation(P< 0.05).The Scr and Ccr of patients in large dose atorvastatin group had no obvious difference with control group(P> 0.05).The incidence rate of CIN of large dose atorvastatin group was 1.72%(2/116),which was obviously lower than that of control group(8/96,P< 0.05).Conclusions:Using large dose atorvastatin at least 3 days before operation can prevent CIN induced by coronary artery intervention diagnosis and treatment.