中国处方药
中國處方藥
중국처방약
CHINA PRESCRIPTION DRUG
2014年
7期
11-13
,共3页
冠状动脉介入术%急性ST段抬高型心肌梗死%阿托伐他汀%对比剂肾病%预防
冠狀動脈介入術%急性ST段抬高型心肌梗死%阿託伐他汀%對比劑腎病%預防
관상동맥개입술%급성ST단태고형심기경사%아탁벌타정%대비제신병%예방
Percutaneous coronary intervention%ST-segment elevation myocardial infarction%Arvastatin%Contrast induced nephropathy%Prevention
目的:探讨强化阿托伐他汀治疗对急诊经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)的预防作用。方法选择行急诊PCI 的急性ST段抬高型心肌梗死(STEMI)患者268例,随机分为常规组(n=132)和强化组(n=136)。常规组及强化组患者分别于PCI术前开始口服阿托伐他汀(20 mg/d及80 mg/d),术后连续使用7 d(20 mg/d及60 mg/d),之后以20 mg/d 维持治疗。观察两组患者术前、术后3 d血清肌酐(Scr)、内生肌酐(Ecr)及估算肾小球滤过率(eGFR)变化情况。结果强化组术后Scr、Ecr 水平及CIN发生率显著性低于常规组,而eGFR显著性高于常规组,差异具有统计学意义(P<0.05)。强化组PCI术后30 d主要不良心血管事件(MACEs)发生率(7.4%)显著性低于常规组(15.2%),差异具有统计学意义(χ2=4.10,P=0.043)。结论STEMI 患者急诊PCI术前强化给予阿托伐他汀治疗可以降低CIN的发生率,改善患者的预后。
目的:探討彊化阿託伐他汀治療對急診經皮冠狀動脈介入治療(PCI)術後對比劑腎病(CIN)的預防作用。方法選擇行急診PCI 的急性ST段抬高型心肌梗死(STEMI)患者268例,隨機分為常規組(n=132)和彊化組(n=136)。常規組及彊化組患者分彆于PCI術前開始口服阿託伐他汀(20 mg/d及80 mg/d),術後連續使用7 d(20 mg/d及60 mg/d),之後以20 mg/d 維持治療。觀察兩組患者術前、術後3 d血清肌酐(Scr)、內生肌酐(Ecr)及估算腎小毬濾過率(eGFR)變化情況。結果彊化組術後Scr、Ecr 水平及CIN髮生率顯著性低于常規組,而eGFR顯著性高于常規組,差異具有統計學意義(P<0.05)。彊化組PCI術後30 d主要不良心血管事件(MACEs)髮生率(7.4%)顯著性低于常規組(15.2%),差異具有統計學意義(χ2=4.10,P=0.043)。結論STEMI 患者急診PCI術前彊化給予阿託伐他汀治療可以降低CIN的髮生率,改善患者的預後。
목적:탐토강화아탁벌타정치료대급진경피관상동맥개입치료(PCI)술후대비제신병(CIN)적예방작용。방법선택행급진PCI 적급성ST단태고형심기경사(STEMI)환자268례,수궤분위상규조(n=132)화강화조(n=136)。상규조급강화조환자분별우PCI술전개시구복아탁벌타정(20 mg/d급80 mg/d),술후련속사용7 d(20 mg/d급60 mg/d),지후이20 mg/d 유지치료。관찰량조환자술전、술후3 d혈청기항(Scr)、내생기항(Ecr)급고산신소구려과솔(eGFR)변화정황。결과강화조술후Scr、Ecr 수평급CIN발생솔현저성저우상규조,이eGFR현저성고우상규조,차이구유통계학의의(P<0.05)。강화조PCI술후30 d주요불양심혈관사건(MACEs)발생솔(7.4%)현저성저우상규조(15.2%),차이구유통계학의의(χ2=4.10,P=0.043)。결론STEMI 환자급진PCI술전강화급여아탁벌타정치료가이강저CIN적발생솔,개선환자적예후。
Objective To explore whether intensive dose arvastatin administered emergency percutaneous coronary intervention(PCI) could reduce the incidence of contrast induced nephropathy(CIN) in patients.Methods 268 patients with ST-segment elevation myocardial infarction(STEMI) underwent emergency PCI randomly received either atorvastatin 80 mg(intensive dose group,n=136) or 20 mg(conventional dose group,n=132) before and 7 days (atorvastatin 60 mg/d and 20 mg/d) after intervention. All patients had long term atorvastatin treatment thereafter(20 mg/d).Serum creatinine(Scr) levels, endogenous creatinine(Ecr) and estimated glomerular filtration rate(eGFR) were measured before and at 3 d after PCI.Results The levels of Scr and Ecr, and the rate of CIN in intensive dose group were significantly lower than conventional dose group, but eGFR were significantly higher than conventional dose group (allP<0.05). We also found that the rate of major adversecardiovascular events(MACEs) in intensive dose group(7.4%) were significantly lower than conventional dose group(15.2%)(χ2=4.10,P=0.043).Conclusions Intensive dose arvastatin administered emergency PCI could reduce the incidence of CIN and improve clinical outcomes inpatients with STEMI on the base of standard intravenous hydration treatment.