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不同剂量辛伐他汀对造影剂肾病患者相关指标的影响
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| 篇名： | 不同剂量辛伐他汀对造影剂肾病患者相关指标的影响 |
| TITLE： | |
| 摘要： | 目的：探讨不同剂量辛伐他汀对造影剂肾病（CIN）患者相关指标的影响。方法：168例行冠脉造影（CAG）术及经皮冠状动脉内支架植入术（PCI）患者随机分为对照组（42例）、低剂量组（42例）、中剂量组（42例）和高剂量组（42例）。对照组患者静脉注射碘海醇注射液20 ml，造影前4 h以2 ml/（kg·h）的速度持续静脉滴注0.9％氯化钠注射液至造影结束，由此至造影后48 h仍以2 ml/（kg·h）的速度持续静脉滴注0.9％氯化钠注射液。造影前48 h低剂量组患者于口服辛伐他汀片20 mg，中剂量组患者口服辛伐他汀服片40 mg，高剂量组患者口服辛伐他汀片80 mg，均为每日1次。各组患者均用药4 d。 观察各组患者造影前后肾功能指标[血肌酐（Scr）、内生肌酐清除率（Ccr）、尿素氮（BUN）]、肾损伤指标[半胱氨酸蛋白酶抑制剂C（CysC）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、尿微量白蛋白（mAlb）]、炎症因子[白细胞介素（IL）-6、超敏C反应蛋白（hs-CRP）]，CIN发生率及不良反应发生情况。结果：造影后，各组患者肾功能指标、各组患者NGAL、mAlb及对照组、低剂量组患者CysC，中、高剂量组造影后48 h CysC均显著高于同组造影前。造影后24 h各指标中、高剂量组＜低剂量组及对照组，差异均有统计学意义（P＜0.05）。造影后48 h中、高剂量组各指标＜低剂量组＜对照组，差异均有统计学意义（P＜0.05）。造影后，各组患者炎症因子水平均显著高于同组造影前，但中、高剂量组＜低剂量组＜对照组，差异均有统计学意义（P＜0.05）。CIN发生率中、高剂量组患者＜低剂量组＜对照组，差异均有统计学意义（P＜0.05）。不良反应发生率高剂量组＞中剂量组＞低剂量组及对照组，差异均有统计学意义（P＜0.05）。结论：中、高剂量辛伐他汀均可有效降低CIN的发生，改善肾功能，降低肾损伤指标及炎症因子水平，但中剂量的安全性优于高剂量。 |
| ABSTRACT： | OBJECTIVE： To explore the effect of different doses of Simvastatin on the related indexes of patients with contrast-induced nephropathy （CIN）. METHODS： 168 patients received coronary angiography surgery （CAG） and percutaneous coronary stent implantation （PCI） were randomly divided into control group （42 cases）， low-dose （42 cases）， medium-dose （42 cases） and high-dose groups （42 cases）， all patients were given Lohexol injection 20 ml. 0.9％ Sodium chloride injection was intravenously infused at a rate of 2 ml/（kg·h） 4 h before radiography until the end， then 0.9％ Sodium chloride injection was still intravenously infused at a rate of 2 ml/（kg·h） in the end and 48 h after radiography. 48 h before radiography， low-dose group was orally given Simvastatin tablet 20 mg Medium-dose group was orally given Simvastatin tablet 40 mg. high-dose group was orally given Simvastatin tablet 80 mg， once a day. All patients were treated for 4 d. Kidney function indexes （Scr，Ccr，BUN）， kidney damage indexes （CysC，NGAL， mAlb）， and inflammatory cytokines[（IL）-6，hs-CRP）] before and after radiography， and the incidences of CIN and adverse reactions in all group were observed. RESULTS：After radiography， kidney function indexes， NGAL and mAlb in all group， CysC in control group and low-dose group， CysC after 48 h radiography in medium-dose， high-dose groups were significantly higher than before， while all the indexes after 24 h radiography in medium-dose， high-dose groups were lower than low-dose group and control group， with statistical significances （P＜0.05）； after 48 h radiography， medium-dose， high-dose groups were lower than low-dose group， which was lower than control group， with statistical significances （P＜0.05）. After radiography， the inflammatory cytokines in all groups were significantly higher than before， while medium-dose， high-dose groups were lower than low-dose group， which was lower than control group， with statistical significances （P＜0.05）. The incidence of CIN in medium-dose， high-dose groups were lower than low-dose group， which was lower than control group， with statistical significances （P＜0.05）. The incidence of adverse reactions in high-dose group was higher than medium-dose group， followed by low-dose group and control group， with statistical significances （P＜0.05）. CONCLUSIONS： Both medium-dose and high-dose of Simvastatin can effectively reduce the incidence of CIN， improve kidney functions， and reduce kidney damage indexes and inflammatory cytokine levels， while the safety of medium-dose is superior to high-dose. |
| 期刊： | 2016年第27卷第30期 |
| 作者： | 岳显文，隋长德 |
| AUTHORS： | YUE Xianwen，SUI Changde |
| 关键字： | 辛伐他汀；造影剂肾病；肾功能；肾损伤；炎症因子 |
| KEYWORDS： | Simvastatin； Contrast-induced nephropathy； Kidney function； Kidney damage； Inflammatory cytokines |
| 阅读数： | 410 次 |
| 本月下载数： | 3 次 |
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