急性冠脉综合征患者择期冠脉介入诊疗术后对比剂肾病的药物干预研究心血管病学专业论文.docxVIP

PAGE PAGE VI 急性冠脉综合征患者择期冠脉介入诊疗术后对比剂肾病的药物干预研究 中文摘要 2、在水化及阿托伐他汀钙片 20 mg 口服的基础上予乙酰半胱胺酸泡腾片 600 mg Bid 术前口服 2 日不能减轻急性肾损伤及降低 CIN 的发生率。 3、尿 NGAL 对于择期行冠脉介入诊疗术的急性冠脉综合征患者术后 CIN 的发生 有早期预测价值。 4、年龄大于 70 岁、糖尿病及对比剂使用剂量是 CIN 发生的独立危险因素。 关键词：急性冠脉综合征；对比剂肾病；冠脉介入诊疗术；尿中性粒细胞明胶酶 相关脂质运载蛋白；阿托伐他汀钙片； 作 者：孟祥飞 指导教师：李 勋 英文摘要 急性冠脉综合征患者择期冠脉介入诊疗术后对比剂肾病的药物干预研究 The drug interventional study of contrast-induced nephropathy in patients with acute coronary syndrome undergoing elective coronary angiography or percutaneous coronary intervention Abstract Objective: To investigate the value of drug intervention on contrast-induced nephropathy (CIN) in patients with acute coronary syndrome (ACS) undergoing elective coronary angiography (CAG) or percutaneous coronary intervention (PCI). Methods: 132 patients with ACS undergoing elective CAG or PCI were selected in the department of cardiology, Suzhou Kowloon Hospital of Shanghai Jiaotong University from January 2012 to January 2013. The mean age was (63.45±10.13) years. Among them, 95 patients were male, and 37 were female. All patients were randomly divided into three groups. Group A (41 patients) was given atorvastatin 20 mg/d and 0.9% sodium chloride with the speed of 1 ml/kg/h from 6h before procedure to 12h after procedure. Group B (48 patients) was given atorvastatin 80 mg once within 24h before procedure besides the drugs of group A. Group C (43 patients) was given N-acetylcysteine (NAC) 600 mg Bid for 2 days before procedure besides the drugs of group A. The venous blood of all patients were drawn and the serum creatine levels were measured before procedure and 48h～72h after procedure, and eGFR were calculated. Urines before and 2h、6h、24h and 48h after procedure were collected for all patients.The neutrophil gelatinase associated lipocalin (NGAL) levels were measured using Enzyme-linked immunospecific assay(ELISA). The incidence of CIN and the changes of Scr ,eGFR and urinary NGAL in the three groups were observed during the periprocedural period. B