阿托伐他汀对冠脉介入术后肾功能的影响

目的观察不同剂量阿托伐他汀对冠脉造影术或经皮冠状动脉介入术（PCI）术后肾功能的影响,并对其可能机制进行分析。方法纳入我院因急性冠脉综合征（ACS）接受冠脉造影术或PCI术的患者120例,随机分为阿托伐他汀常规剂量治疗组（常规组,20mg/d,n=60）和阿托伐他汀高剂量治疗组（高剂量组,术前40mg/d×3d,术后20mg/d,n=60）。术前、术后24h检测血清不规则趋化因子（FKN）的水平,术前、术后3天和术后7天检测血肌酐（Scr）、评估肾小球滤过率（eGFR）、血胱抑素（Cys）等,同时分析FKN与上述肾功能指标的相关性。结果术后24h高剂量治疗组FKN浓度低于常规剂量治疗组（P〈0.05）;术后3天高剂量组患者Scr、Cys低于常规组,而eGFR则高于常规组,存在统计学差异（P〈0.05）。两组的对比剂肾病（contrast induced nephropathy,CIN）发病率存在统计学差异（6.67%vs.16.67%,P〈0.05）。相关性分析结果显示FKN浓度与患者Scr、Cys水平呈正相关,与eGFR呈负相关（P〈0.05）。结论术前强化阿托伐他汀治疗可预防CIN,其机理可能与FKN有关。

The effection of atorvastatin on kidney function after perutaneous coronary intervention

Objective To observe the influences of atorvastatin in different doses on kidney function after coronary angiography （ CAG ） or percutaneous coronary intervention （ PCI ） , and analyze the mechanism. Methods The patients （ n =120 ） accepted CAG or PCI because of acute coronary syndrome （ ACS ） were selected and randomly divided into group treated with routine dose atorvastatin （ routine group, 20mg/d , n =60 ） and group with high-dose atorvastatin （ high-dose group,preoperation 40mg/d × 3d , postoperation 20mg/d , n =60 ） , The level of fractalkine （ FKN ） was detected before and 24 hours after the operation. The levels of serum creatinine （ Scr ） , glomerular filtration rate （ GFR ） and cystatin were detected before the operation and 3 days and 7 days after the operation, and at the same time the correlation between FKN and the above mentioned indexes was analyzed. Results The level of FKN was lower in high-dose group than that in routine group 24 hour after the operation （ P 0.05 ） . The levels of Scr and cystatin were lower and GFR level was higher in highdose group than those in routine group 3 days after the operation （ P 0.05 ） . The incidence of contrast induced nephropathy （ CIN ） had statistical difference between two groups （ 6.67% vs. 16.67%, P 0.05 ） . The results of correlation analysis showed that FKN level was correlated to the levels of Scr and cystatin, and negatively related to GFR level （ P 0.05 ） . Conclusion The intensive treatment of atorvastatin can prevent CIN and the mechanism may be related to FKN.