大剂量阿托伐他汀序贯治疗对急性非ST段抬高型心肌梗死患者围手术期对比剂肾病的影响
DOI:
作者:
作者单位:

(1.广州医科大学附属清远市人民医院心内科,广东省清远市 511518;2.中南大学湘雅医院心内科,湖南省长沙市 410008)

作者简介:

段鹏,硕士,主治医师,研究方向为冠状动脉介入治疗和心脏电生理,E-mail为cardiodp@sina.com。

通讯作者:

基金项目:


Effect of High Dose Atorvastatin Sequential Treatment on Contrast-induced Nephropahty in Non-ST-segment Elevation Acute Myocardial Infarction Patients Underwent Elective Percutaneous Coronary Intervention
Author:
Affiliation:

1.Department of Cardiology, Affiliated Qingyuan People's Hospital, Guangzhou Medical University, Qingyuan, Guangdong 511518, China;2.Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China)

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
    摘要:

    目的 探讨大剂量阿托伐他汀序贯治疗对急性非ST段抬高型心肌梗死行择期经皮冠状动脉介入治疗(PCI)患者对比剂肾病(CIN)的影响。方法 将100例急性非ST段抬高型心肌梗死并择期行PCI患者随机分为大剂量阿托伐他汀序贯治疗组(简称序贯治疗组)和对照组。所有患者入院即刻给予80 mg阿托伐他汀钙,随后40 mg/d,术前均给予水化治疗。序贯治疗组术前6 h内追加40 mg阿托伐他汀钙,对照组术前未追加阿托伐他汀钙。所有患者分别于PCI术前、术后24 h、48 h测定并比较血清肌酐(Scr)、内生肌酐清除率(Ccr)和CIN发生率。结果 两组患者术前、术后24 h、48 h Scr和Ccr相比差异均无统计学意义;与术前相比,序贯治疗组术后24 h、48 h Scr和Ccr均无明显变化,对照组术后24 h Scr和Ccr无明显变化,术后48 h Scr明显上升,Ccr明显下降(P<0.05)。与术后24 h比较,两组术后48 h Scr明显上升,Ccr明显下降(P=0.00)。所有CIN患者术后7~10天Scr均降至正常范围内;两组患者CIN发生率相比差异无统计学意义(16%比15%,P=0.585)。结论 对于术前已使用阿托伐他汀钙40 mg/d调脂方案患者,围手术期再次予阿托伐他汀钙40 mg治疗并不能降低CIN发生率。

    Abstract:

    Aim To study the beneficial effects of high dose atorvastatin sequential treatment in preventing contrast-induced nephropathy (CIN) in acute non-ST-segment elevation acute myocardial infarction (NSTEMI) patients underwent elective percutaneous coronary intervention (PCI). Methods One hundred patients with NSTEMI undergone elective PCI were randomly divided into two groups:high dose atorvastatin sequential treatment group (sequential treatment group for short) and control group. All patients were given 80 mg atorvastatin instantly and then 40 mg once a day. On the basis of hydration therapy, sequential treatment group received additional 40 mg atorvastatin at 6 hours before PCI. Serum creatinine (Scr), endogenous creatinine clearance rate (Ccr) and the incidence rate of CIN were measured and compared 24 hours and 48 hours post-PCI. Results The levels of Scr, Ccr had no significant difference in the two groups at all time points. Compared with the preoperative, Scr and Ccr had no significant changes postoperatively in sequential treatment group. In control group, Scr and Ccr had no significant change 24 hours postoperatively, Scr had significantly increased, Ccr had significantly decreased after 48 hours (P<0.05). Compared with 24 h postoperatively, Scr had significantly increased, Ccr had significantly decreased (P=0.00). Scr decreased to the normal range after 7~10 days in all patients with CIN. The CIN incidence rate had no significant difference in the two groups (16% vs. 15%, P=0.585). Conclusion For patient who had used lipid-lowering program before PCI:40 mg/d atorvatatin, the strategy of re-load atorvastatin 40 mg can not reduce the CIN incidence rate.

    参考文献
    相似文献
    引证文献
引用本文

段鹏,张小勇,张赛丹.大剂量阿托伐他汀序贯治疗对急性非ST段抬高型心肌梗死患者围手术期对比剂肾病的影响[J].中国动脉硬化杂志,2016,24(7):711~714.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:2015-07-21
  • 最后修改日期:2015-11-04
  • 录用日期:
  • 在线发布日期: 2016-07-05