摘要
目的:和常规治疗组对比,观察经皮冠状动脉介入术(PCI)术前强化他汀治疗联合碘克沙醇对70岁以上患者PCI术后的肾功能的保护作用。方法:2011年3月至2013年9月入院接受择期PCI手术的70岁以上急性冠脉综合征(ACS)患者共389例,随机分为联合治疗组188例,对照组201例。联合治疗组入院后给予阿托伐他汀40 mg/d,并于PCI术前12 h给予阿托伐他汀80 mg,术前2 h给予阿托伐他汀40 mg,并使用碘克沙醇(320 mg L/m L)进行PCI治疗。对照组入院后给予阿托伐他汀20 mg/d,并且使用碘海醇(350 mg L/m L)进行PCI治疗。比较两组对比剂肾病的发生率,及对转氨酶(ALT)和肌酸激酶(CK)的影响。结果:联合治疗组对比剂肾病的发生率为14.89%(28例),对照组则高达37.31%(75例),显著高于联合治疗组(P<0.01)。两组对ALT及CK的影响差异无统计学意义(P>0.05)。结论:术前强化他汀治疗联合碘克沙醇可显著减少70岁以上PCI患者对比剂肾病的发生;并且安全性良好。可以作为70岁以上患者PCI手术的常规用药方案。
AIM： To observe the effectivity and safety of high dose atorvastatin combined with iodixanol in preventing contrast induced nephropathy（ CIN） in elderly PCI patients.METHODS： 389 elective PCI patients older than 70 years old were divided into two groups.188 patients in high dose atorvastatin combined with iodixanol group given atorvastatin（ 40 mg / d） after admission,and 80 mg atorvastatin 12 hours before PCI,40 mg atorvastatin 2 hours before PCI; and iodixanol used in PCI.201 patients in control group given atorvastatin（20 mg /d） after admission,and iohexol used in PCI.The incidence of contrast induced nephropathy（ CIN） in each group was observed,and the levels of ALT and CK were measured in each group.RESULTS： The incidence of CIN in high dose atorvastatin combined with iodixanol group was 14.89%（ 28 cases）,and the incidence of CIN in control group was 37.31%（75 cases）.The incidence of CIN in control group was significantly higher than that in the other group（ P 〈0.01）.The levels of ALT and CK were similar in both groups（ P〉 0.05）.CONCLUSION： High dose atorvastatin combined with iodixanol can reduce the incidence of CIN in patients older than 70 years old after PCI.The safety is good.And it can be conventional therapy scheme in patients older than 70 years old after PCI.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2016年第1期82-86,共5页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
国家"十二五"科技支撑计划课题(2011BAI11B01)
