不同剂量瑞舒伐他汀对急性冠状动脉综合征介入术后肾功能的影响

目的分析不同剂量瑞舒伐他汀对急性冠状动脉综合征（ACS）患者经皮冠状动脉介入术（PCI）后肾功能的影响。方法将82例行PCI后的ACS患者随机分为强化组和常规组各41例。强化组给予瑞舒伐他汀钙片20mg口服，每天1次；常规组给予瑞舒伐他汀钙片10mg口服，每天1次；分别于术前及术后第1、3、5天测定超敏C反应蛋白（hs-CRP）、血清胱抑素（Cys-C）、血清肌酐（Scr）水平并估测肾小球滤过率（e-GFR）以对比2组肾功能情况，同时对比2组患者造影剂肾病（CIN）的发病率。结果2组术前hs-CRP、Cys-C、Scr、e-FR水平比较差异无统计学意义（P〉0．05）。2组术后第3天hs-CRP水平均明显低于术前，且强化组较常规组降低更明显（P〈0．05）；常规组术后第3天Scr水平高于术前水平（P〈0．05）；常规组术后第1天Cys-C水平明显高于术前，且明显高于强化组，差异均有统计学意义（P〈0．05）。2组CIN发病率比较差异无统计学意义（P〉0．05）。结论PCI术前给予高剂量瑞舒伐他汀可降低对比剂导致的肾脏功能损伤，Cys-C在造影剂肾病的早期检测中可能具有一定的临床意义。

Influence of different doses of rosuvastatin on the renal function of acute coronary syndrome after interventional postoperative

Objective To analysis the influence of different doses of rosuvastatin on the renal function of acute coro- nary syndrome（ACS）after percutaneous coronary intervention （PCI）. Methods 82 cases patients with ACS after PCI were randomly divided into intensive group and conventional group, each of 41 cases. Intensive group was treated with rosuvastatin calcium tablet 20mg, one time a day;Conventional group was treated with rosuvastatin statin calcium 10mg, one time a day. De- termined the level of ultra-sensitivity C-reactive protein （hs-CRP） ,blood Cys-C and serum creatinine （Scr） on the 1,3,5 be- fore and after surgery. Estimated the glomerular filtration rate （e-GFR） in order to evaluation the renal function. Compared the prevalence of contrast-induced nephropathy （CIN）. Results The difference of hs-CRP, Cys-C, Scr, e-GFR between two groups was not statistically significant（ P 〉 0.05 ）. The level of hs-CRP in two groups after 3 days of postoperative were both lower than that of preoperative （P 〈 0.05 ） , and the level of hs-CRP in intensive group after three days of postoperative was lower than that of conventional group（ P 〈 0.05 ）. The level of Scr in conventional group after three days of postoperative was higher that of preoperatiw：（ P 〈 0.05 ）, but the difference of Scr between intensive group and conventional group after three days of postopera- tive was not statistically significant（ P 〉0.05 ）. The level of Cys-C in conventional group after one days of postoperative was higher that of preoperative（P 〈 0.05）, and the level of Cys-C in conventional group after one days of postoperative was higher that of intensive group, the difference was statistically significant （ P 〈 0.05 ）. The difference of e-GFR in two groups was not statistically significant （P 〈 0.05）. Conclusion The applied of high doses of rosuvastatin in the ACS patients before PCI can reduce the renal dysfunction induced by contrast agent. Cys-C may has some clinical significance in the early detection of con- trast-induced nephropathy.