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2ml/(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(Cys C)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿微量白蛋白(m Alb)]、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、m Alb及对照组、低剂量组患者Cys C,中、高剂量组造影后48 h Cys C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。
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（Cys C,NGAL,m Alb）,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 m Alb in all group,Cys C in control group and low-dose group,Cys C 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 g
出处
《中国药房》
CAS
北大核心
2016年第30期4206-4209,共4页
China Pharmacy
关键词
辛伐他汀
造影剂肾病
肾功能
肾损伤
炎症因子
Simvastatin
Contrast-induced nephropathy
Kidney function
Kidney damage
Inflammatory cytokines
