Objective To explore the role of short-term, high-dose atorvastatin in the prevention of contrast-induced nephropathy ( CIN ) in patients with renal insufficiency after percutaneous coronary intervention ( PCI ).Methods 41 patients with coronary heart discease ( CHD ) and renal insufficiency underwent scheduled PCI.They received either 80 mg/d of atorvastatin ( study group,n =21 ),or 20 mg/d of atorvastatin ( control group,n =20 ) for 3 days before PCI.Serum creatinine ( SCr )levels were measured before and on days 1,2,and 3 after PCI.CIN was defined as an increase in SCr values of ≥ 25％ or ≥ 0.5 mg/dl from the baseline within 3 days after PCI.Results There were no significant differences in levels of SCr between the two groups at different time points ( P ＞ 0.05 ).The incidence rate of CIN did not differ significantly between the two groups ( one in each group,P＞ 0.05 ).There was no significant difference in the peak level of SCr between the study group and the control group after intervention ( 232.4 μmol/L vs.227.6 μmol/L,P＞ 0.05 ).Conclusions On the basis of standard intravenous hydration,a short-term administration of high doses of atorvastatin before and after contrast exposure fails to decrease CIN occurrence in CHD patients with pre-existing renal insufficiency.%目的 探讨短期、大剂量他汀类药物对合并肾功能不全的冠心病患者择期冠状动脉介入治疗( PCI)术后对比剂肾病(CIN)的预防作用.方法 选择行择期PCI的冠心病合并肾功能不全患者41例,将其随机分为研究组(n=21)和对照组(n=20).分别于入院时开始口服阿托伐他汀80 mg/d或20 mg/d,连续使用3d.PCI术前,PCI术后第1、2、3d检测所有患者血清肌酐( SCr).CIN定义为:使用对比剂后3d内SCr较基础水平升高≥25％,或绝对值升高≥0.5 mg/dl.结果 对照组与研究组不同时间点间SCr比较差异均无显著性(P＞0.05).所有患者中,共有2例发生CIN( 4.88％),对照组和研究组各有1例发生CIN,二者发生率比较差异无显著性(P＞ 0.05 ).对照组SCr峰值为227.6 μmol/L,研究组SCr峰值为232.4 μmol/L,二者比较差异无显著性(P＞0.05).结论 在标准水化治疗的基础上,短期、大剂量他汀类药物并不能降低合并肾功能不全的择期PCI患者术后CIN的发生率.
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