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 |
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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: | 457 次 |
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