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目的研究阿托伐他汀在对比剂肾病预防中的作用。方法将100例单纯冠状动脉造影的患者随机分为他汀组和对照组,在全部采用水化治疗的基础上,他汀组于冠状动脉造影前3天每晚顿服阿托伐他汀20mg,对照组未服用阿托伐他汀及其他调脂药。观察术前及术后第1天、第2天血肌酐(Scr)、尿素氮(BUN)、血浆光抑素C(CysC)的变化,计算出肌酐清除率(Ccr)和肾小球滤过率(GFR);留尿标本测定尿肌酐、尿N-乙酰-β-D葡萄糖苷酶(NAG)、尿渗透压。结果阿托伐他汀组GFR术后1、2d显著高于对照组[(96.10±13.93)mg/L比(70.34±12.38mg/L),P<0.05]、[(96.84±15.38)mg/L比(83.46±14.34)mg/L,P<0.05];尿NAG/Cr术后1、2d阿托伐他汀组显著低于对照组[(1.12±0.30)mg/L比(1.34±0.33mg/L),P<0.05]、[(1.28±0.31)mg/L比(1.42±0.35)mg/L,P<0.05]。结论对比剂可造成轻微的一过性肾损害。阿托伐他汀于冠状动脉造影术前3d给药,可改善患者肾小球滤过功能及近端肾小管功能,提示可能有预防对比剂肾病的作用。
Objective To study the role of atorvastatin in the prevention of contrast-induced nephropathy. Methods 100 patients with simple coronary angiography were randomly divided into statin group and control group. On the basis of all the hydration therapy, 20 mg of atorvastatin was given to the statin group at night before coronary angiography three days before, and the control group Not taking atorvastatin and other lipid-lowering drugs. The changes of serum creatinine (Scr), blood urea nitrogen (BUN) and plasma CysC (CysC) before and 1 day and 2 days after operation were observed, and the creatinine clearance (Ccr) and glomerular filtration Rate (GFR); urinary specimens were measured urinary creatinine, urine N-acetyl-β-D-glucosidase (NAG), urinary osmolality. Results The GFR of atorvastatin group was significantly higher than that of the control group at day 1,2 after GFR ([(96.10 ± 13.93) mg / L vs (70.34 ± 12.38 mg / L, P <0.05] (83.46 ± 14.34) mg / L, P <0.05]; urinary NAG / Cr at 1 and 2 days after operation in atorvastatin group was significantly lower than that in control group [1.12 ± 0.30 mg / L vs 1.34 ± 0.33 mg / L, P <0.05], [(1.28 ± 0.31) mg / L vs (1.42 ± 0.35) mg / L, P <0.05; Conclusion Contrast agents can cause minor transient renal damage. Atorvastatin administered at 3 days prior to coronary angiography improved glomerular filtration and proximal tubular function, suggesting that there may be a role in the prevention of contrast agent nephropathy.