大剂量氟伐他汀预防脑血管造影术后造影剂肾病的疗效观察

摘要

Objective To investigate the effect of Effectiveness and safety of high dose fluvastatin for preventing postoperative con-trast induced nephropathy(CIN)in digital subtraction angiography (DSA).Methods One hundred and twenty DSA patients from A-pril 2012 to August 2014 were divided into 3 groups:control group(n=35),convention group(n=40)administered by 40 mg fluvas-tatin sodium capsule at each night of three days before DSA test,strength group(n=45)administered by 80 mg fluvastatin sodium capsule at each night of three days before DSA test.The preoperative and postoperative renal function,liver function and morbidity of CIN were observed.Results Compared with pre operation,postoperative Scr,Bun and Ccr in control group had significant differ-ences(P<0.05).There was significant difference in preoperative and postoperative Scr,Bun and Ccr between strength group and control group or convention group(P<0.05).The morbidity of CIN was 28.6% in control group,10.0% in conventional,0.0% in strength group,respectively(P<0.05).Conclusion High dose fluvastatin was relatively safe and effective to prevent postoperative CIN in DSA.%目的：探讨大剂量氟伐他汀预防脑血管造影术后造影剂肾病(CIN)的有效性及安全性。方法回顾性分析我院2012年4月—2014年8月行全脑血管造影检查的病人120例,其中对照组35例,DSA检查前未服用他汀类药物；常规组40例,DSA检查前3 d开始服用氟伐他汀钠胶囊每晚40 mg；强化组45例,DSA检查前3 d开始服用氟伐他汀钠缓释片每晚80 mg。观察3组病人术前及术后肾功能、肝功能变化及 CIN的发病率。结果对照组术后3 d肌酐(Scr)、血清尿素氮(Bun)、内生肌酐清除率(Ccr)与术前比较均有统计学意义(P<0.05)；强化组手术前后 Scr、Bun、Ccr变化值与对照组、常规组比较差异有统计学意义(P<0.05)。3组病人 CIN发病率分别为对照组28.6%(10/35)；常规组10.0%(4/40)；强化组0,常规组的 CIN发病率低于对照组(P<0.05),而强化组 CIN发病率明显低于对照组及常规组(P<0.05)。3组病人术后7 d丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)与术前比较均无明显升高(P>0.05)。结论术前服用氟伐他汀可以降低造影剂肾病的发生率,且这种预防作用随着药物剂量的增加而增强,且未增加肝功能损害的风险,大剂量氟伐他汀预防脑血管造影术后 CIN相对安全、有效。