阿托伐他汀与N-乙酰半胱氨酸预防PCI术后造影剂肾病的效果比较

目的:比较阿托伐他汀与N-乙酰半胱氨酸对冠心病患者经皮冠状动脉介入治疗(PCI)后造影剂肾病的预防效果。方法:将150例冠心病患者随机分为阿托伐他汀治疗组(50例),N-乙酰半胱氨酸治疗组(50例)和对照组(50例)。在充分水化治疗的基础上,阿托伐他汀组在PCI术前1 d口服阿托伐他汀80 mg,PCI术后每天口服阿托伐他汀40 mg,持续3 d;N-乙酰半胱氨酸组在PCI术前1 d分两次服用N-乙酰半胱氨酸泡腾片1 200 mg,术后连续服用3 d;对照组不做进一步处理。然后分别测定并比较3组患者造影前及造影后24 h、48 h、72 h的血肌酐(Scr)和造影剂肾病(CIN)的发生率。结果:术后72 h两治疗组Scr增加值及CIN的发生率均明显低于对照组(P<0.05),其中阿托伐他汀治疗组Scr增加值及CIN的发生率明显低于N-乙酰半胱氨酸治疗组(P<0.05)。结论:阿托伐他汀及N-乙酰半胱氨酸对冠心病患者PCI术后造影剂肾病的发生都有一定的预防保护作用,阿托伐他汀的预防保护作用更明显。

Comparative study of atorvastain and N-acetylcysteine on prevention of contrast-induced nephropathy after percutaneous coronary intervention

Objective： To compare the protective effects of atorvastatin and N-acetylcysteine on prevention of contrast-induced nephropathy（ CIN） after percutaneous coronary intervention（ PCI）.Methods： 150 cases of coronary heart disease were randomly divided into three groups： atorvastain group,N-acetylcysteine group and control group. On the basis of the hydration therapy,the patients in Atorvastain group received atorvastatin 80 mg orally on the day before PCI and 40 mg orally after PCI once a day for 3 days. The patients in N-acetylcysteine group received N-acetylcysteine1 200 mg on the day before PCI and 1 200 mg after PCI twice a day for 3 days. Then the levels of Scr and incidence rate of CIN were measured and compared at 24 hours,48 hours and 72 hours after contrast administration between groups. Results： The added value of Scr and the incidences of CIN in atorvastain group and N-acetylcysteine group were significantly lower than the control group（ P 〈 0. 05）. The added value of Scr and the incidence of CIN in atorvastain group was significantly lower than N-acetylcysteine group（ P 〈 0. 05）. Conclusion： Atorvastatin and N-acetylcysteine have a good preventive and protective effect on CIN after PCI,and the preventive protection of atorvastatin is more obvious.