阿托伐他汀强化预防经皮冠状动脉介入治疗术后造影剂肾病及其相关危险因素研究.docVIP

阿托伐他汀强化预防经皮冠状动脉介入治疗术后造影剂肾病及其相关危险因素研究 　　[摘要] 目的 研究强化阿托伐他汀钙治疗对经皮冠状动脉介入术后造影剂肾病的干预作用，并探讨其作用机制及其发生的相关因素。 方法 入选104例冠心病患者，根据围术期他汀治疗方案的不同，将其分为强化他汀治疗组（A组，54例）、常规他汀治疗组（B组，50例），所有患者经皮冠状动脉介入治疗术前及术后1 d均检测超敏C反应蛋白（hs-CRP）、胱抑素C（Cys-C）和血肌酐（Scr）水平。 结果 术前两组患者Scr、Cys-C、hs-CRP水平比较差异无统计学意义（P 0.05），术后第1天A组患者Cys-C、hs-CRP、Scr水平均显著低于B组（P 0.05）。术后A组有1例（1.85%）患者出现造影剂肾病，B组有4例（8.00%）患者出现造影剂肾病，差异有高度统计学意义（P 0.01）。经过Logistic回归分析显示，年龄、术前Cys-C、术前hs-CRP、高血压、糖尿病为造影剂肾病发生的危险因素。 结论 阿托伐他汀钙早期干预对经皮冠状动脉介入术后患者的肾功能具有保护作用；年龄、术前Cys-C、hs-CRP、高血压、糖尿病等为造影剂肾病发生的独立危险因素。 　　[关键词] 阿托伐他汀；造影剂肾病；危险因素 　　[中图分类号] R692 [文献标识码] A [文章编号] 1673-7210（2015）05（c）-0074-04 　　[Abstract] Objective To explore the effect of high-dose Atorvastatin Calcium in preventing radiographic contrast nephropathy after percutaneous coronary intervention and to discuss its mechanism and related risk factors. Methods One hundred and four cases of patients with coronary heart disease were selected， according to the differences of statins therapeutic regimen in perioperative period， they were divided into intensive statin group （group A， n = 54） and conventional statin group （group B， n = 50）. The serum creatinine （Scr）， cystain C （Cys-C）， high sensitivity C-reactive protein （hs-CRP） of all patients were respectively calculated before percutaneous coronary intervention and one day after percutaneous coronary intervention. Results ①Before operation， the differences of Scr， Cys-C and hs-CRP between two groups were not statistically significant （P 0.05）. On the first day after operation， the levels of Cys-C， hs-CRP， and Scr of group A were significantly lower than those of group B （P 0.05）. After operation， there was one patient （1.85%） with contrast induced nephropathy in group A， 4 patients （8.00%） with contrast induced nephropathy in group B， the difference was statistically significant （P 0.01）. Logistic analysis showed that age， preoperative Cys-C， hs-CRP， hypertension， diabetes were the risk factors of contrast induced nephropathy. Conclusion