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阿托伐他汀强化治疗对缺血性脑血管疾病患者介入术后CIN及炎症反应的影响 被引量:2

Influence of intensive atorvastatin therapy on CIN and inflammatory response in patients with ischemic cerebrovascular disease after interventional surgery
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摘要 目的:探讨阿托伐他汀强化治疗对缺血性脑血管疾病患者介入术后造影剂肾病(CIN)及全身炎症反应的影响。方法:选择在我院接受介入术的118例缺血性脑血管疾病患者,按服用阿托伐他汀剂量的不同分为强化组(术前、术后分别口服阿托伐他汀80mg/d和40mg/d)与常规治疗组(术前3d及术后口服阿托伐他汀20mg/d),各59例,比较两组患者术前24h、术后72h肾功能指标及炎症反应指标水平。结果:与治疗前比较,强化组术后肾功能指标中胱抑素C(CysC)水平明显升高,常规治疗组术后血CysC、肌酐(Scr)、β2-微球蛋白(β2-MG)水平明显升高,肌酐清除率(Ccr)水平明显降低(P<0.05或<0.01);与常规治疗组比较,强化组治疗后Scr[(93.97±13.83)μmol/L比(78.44±17.36)μmol/L]、β2-MG[(2.88±0.64)mg/L比(2.46±0.61)mg/L]、CysC[(1.24±0.07)mg/L比(0.88±0.10)mg/L]水平明显降低,Ccr[(68.92±17.38)ml/min比(82.22±15.94)ml/min]水平明显升高(P均=0.001)。术后两组患者炎症反应指标水平均有明显降低,且与常规治疗组比较,强化组高敏C反应蛋白[(13.53±3.82)mg/L比(11.31±3.72)mg/L]、白介素6[(99.87±24.76)ng/L比(85.73±24.17)ng/L]、肿瘤坏死因子α[(286.67±78.38)ng/L比(252.61±80.02)ng/L]水平降低更显著(P<0.05或<0.01)。强化组CIN发生率显著低于常规治疗组(1.69%比11.90%,P=0.028)。结论:阿托伐他汀强化治疗能够显著降低缺血性脑血管疾病患者介入术后造影剂肾病的发生率,抑制全身炎症反应,安全可靠。 Objective: To explore influence of intensive atorvastatin therapy on contrast-induced nephropathy (CIN) and systemic inflammatory response in patients with ischemic cerebrovascular disease (ICD) after interventional sur- gery. Methods: A total of 118 ICD patients undergoing interventional surgery in our hospital were selected. Accord- mg to atorvastatin dose, they were divided into intensive group (n = 59, received atorvastatin 80mg/d before surgery and 40mg/d after surgery) and routine control group (n = 59, received atorvastatin 20mg/d 3d before surgery and af- ter surgery). Levels of renal function indexes and inflammatory indexes 24h before and 72h after surgery were com- pared between two groups. Results: Compared with before treatment, after treatment, there was significant rise in cystatin C (CysC) level in intensive group significant rise in levels of serum CysC, creatinine (Scr), and J]2-micro- globulin (x2-MG), and significant reduction in creatinine clearance rate (Ccr) in routine control group (P〈0.05 or d0.01); compared with routine control group after treatment, there were significant reductions in levels of Scr [ (93.97~ 13.83) mol/Lvs. (78.44± 17.36) μmol/L], 2-MG[ (2.88±0.64) mg/Lvs. (2.46±0.61) mg/L] and CysC [ (1.24 ± 0.07) mg/L vs. (0.88 ± 0.10) mg/L], and significant rise in Ccr [ (68. 92 ± 17. 38) ml/min vs. (82.22 ± 15.94) ml/min in intensive group, P = 0. 001 all. There were significant reductions in inflammatory index levels in both groups after surgery, compared with routine control group, there were significant reductions in levels of high sensitive C reactive protein [ (13.53 ± 3.82) mg/L vs. (11.31 ± 3.72) mg/L], interleukin-6 [ (99.87 ± 24.76) ng/L vs. (85.73 ± 24. 17) ng/L] and tumor necrosis factor a (286.67 ± 78.38) ng/L vs. (252, 61 ± 80.02) ng/L] in intensive group, P〈0.05 or d0.01. Incidence rate of CIN in intensive group was significantly lower than that of ro
出处 《心血管康复医学杂志》 CAS 2017年第6期623-627,共5页 Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词 脑缺血 脑血管造影术 阿托伐他汀 Brain ischemia Cerebral angiography Atorvastatin
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