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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2014年第1期

页码:

35-38

栏目:

临床研究

出版日期:

2013-12-02

文章信息/Info

Title:

Preventive effects of rosuvastatin combined with venous hydration on contrast-induced nephropathy in patients with coronary heart diseases undergoing intervention therapy

作者:

李永勤; 吴娟娟; 范艳梅; 胡艳超; 张 岩; 郝广华; 王小芳

(西安交通大学医学院第二附属医院心内科，陕西 西安 710004)

Author(s):

LI Yong-qin;  WU Juan-juan;  FAN Yan-mei;  HU Yan-chao;  ZHANG yan;  HAO Guang-hua;  WANG Xiao-fang

(Department of Cardiology, Second Hospital, Xi’an Jiaotong University, Xi’an 710004, Shaanxi, China)

关键词:

瑞舒伐他汀; 生理盐水静脉水化治疗; 对比剂肾病

Keywords:

rosuvastain;  venous sodium chloride hydration;  contrast-induced nephropathy

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的:观察在使用强化瑞舒伐他汀情况下静脉水化治疗对预防冠心病介入诊治后对比剂肾病的疗效。方法:选择冠心病介入诊治患者210例，强化瑞舒伐他汀并水化治疗组（水化治疗组）108例（术前及术后1周内应用瑞舒伐他汀20 mg/d，1周后减量为10 mg/d，同时于术前及术后6 h给予生理盐水静脉水化治疗）；对照组102例（术前及术后1周内应用瑞舒伐他20 mg/d，1周后减量为10 mg/d）。观察介入诊治后1周内对比剂肾病的发生率、肌酐、肌酐清除率以及高敏C反应蛋白（hsCRP）含量的变化。结果:术后1 d两组血肌酐水平都较术前明显升高（P<0.05，P<0.01），与对照组相比，水化治疗组于术后2 d血肌酐已降至术前水平；于术后1周，两组血肌酐恢复至术前水平。同样，两组患者血肌酐清除率在术后均下降，最低在术后1 d，后逐渐恢复。水化治疗组血肌酐清除率在术后2 d已经恢复至术前水平，而对照组仍明显低于术前水平（P<0.05），于术后1周恢复至术前水平。水化治疗组对比剂肾病的发生率为5.6%，而对照组对比剂肾病的发生率为12.7%。两组患者术后1 d血浆hsCRP的含量与术前相比均明显升高，水化治疗组于术后2 d显著低于对照组（P<0.05）；于术后1周两组间无显著差异。结论:静脉水化治疗联合强化瑞舒伐他汀治疗可明显降低冠心病介入诊治后对比剂肾病的发生率。

Abstract:

AIM:To study the preventive effects of rosuvastatin combined with venous hydration on contrast-induced nephropathy in patients with acute coronary syndromes undergoing intervention therapy. METHODS: Two hundred and ten patients were randomly divided into two groups: intensive treatment group (108 patients) in which rosuvastain 20 mg/day was administrated before and 1 week after intervention combined with venous hydration 6 h before and after intervention and control group (102 patients) in which only rosuvastain 20 mg/day was administrated before and after intervention. Serum level of creatinine and creatinine clearance rate, incidence of contrast-induced nephropathy and serum level of hsCRP were observed. RESULTS: One day after intervention, serum level of creatinine increased in both intensive group and control group (P<0.05), but 2 days after intervention the serum level of creatinine in the intensive group decreased compared with that in control group and was equal to the level before intervention. One week after the intervention, the serum level of creatinine decreased to the level before intervention in both intensive group and control group. After intervention, creatinine clearance rate decreased in both intensive group and control group. The creatinine clearance rate in intensive group increased to the level before intervention 2 days after intervention; whereas the rate in the control group was still markedly lower than the level before intervention. The creatinine clearance rate in the control group increased to the level before intervention 1 week after the intervention. The incidence of contrast-induced nephropathy in the intensive group was 5.6% (six patients), whereas the incidence in the control group was 12.7% (13 patients). Serum hsCRP levels increased significantly in both intensive group and control group 1 day after intervention, but from 2 days to 1 week after intervention the serum level of hsCRP decreased significantly compared with that in control group (P<0.05). CONCLUSION: Intensive treatment of rosuvastatin combined with venous sodium chloride hydration markedly decreases the incidence of contrast-induced nephropathy in patients with acute coronary syndrome undergoing intervention therapy.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2013-05-28.作者简介:李永勤,副主任医师，博士 Email：wsxlyq@163.com

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更新日期/Last Update: 2014-01-20