不同剂量瑞舒伐他汀对经皮冠脉介入术后对比剂肾病的影响

摘要

Objective To evaluate the effect of rosuvastatin in different dosage on contrast induced nephropathy (CIN) after percutaneous coronary intervention(PCI).Methods We randomly assigned 240 patients undergoing PCI to accept rosuvastatin with 20 mg (in the intensive treatment group) or rosuvastatin 10 mg(in the routine group) before and after the procedure.CIN was defined as an absolute increase of serum creatinine ＞ 44.2 μ mol/L within 48-72 hours after the procedure.Results CIN occurred in 12 cases (10％) in the intensive treatment group and 16 cases (13％) in the routine group (P=0.002).There was statistical significant difference between two groups in incidence of requiring renal-replacement therapy,in-hospital death,requiring intra-aortic balloon pump (IABP) and so on.Conclusion Rosuvastatin can reduce the risk of CIN or other clinical outcomes in patients undergoing PCI.%目的 探讨不同剂量瑞舒伐他汀对经皮冠脉介入术后对比剂肾病的影响.方法 2011年5月至2012年9月在我科住院拟行择期经皮冠脉介入术(PCI)的患者240例,所有患者随机分为强化组及常规组各120例.强化组在术前及术后给予瑞舒伐他汀20 mg/d,共30 d；常规组术前及术后给予常规剂量10 mg/d,共30 d.CIN定义为:在使用对比剂后的72h内,血清中肌酐浓度升高＞0.5 mg/dl(＞44μ mol/L)或者较原基础值升高25％以上.结果 强化组CIN发生率明显低于常规组,两组间差异有统计学意义(10％vs 13％,x2=0.458,P=0.002).两组术后院内临床事件包括需要肾脏替代治疗、死亡、需要IABP治疗等方面差异有统计学意义(P＜0.05).结论 术前及术后给予瑞舒伐他汀强化治疗,能够显著减少CIN的发生,同时减少院内不良事件发生.