CAJ | 학술논문

目的：研究强化阿托伐他汀钙治疗对经皮冠状动脉介入术后造影剂肾病的干预作用，并探讨其作用机制及其发生的相关因素。方法入选104例冠心病患者，根据围术期他汀治疗方案的不同，将其分为强化他汀治疗组(A组，54例)、常规他汀治疗组(B组，50例)，所有患者经皮冠状动脉介入治疗术前及术后1 d均检测超敏C反应蛋白(hs-CRP)、胱抑素C(Cys-C)和血肌酐(Scr)水平。结果术前两组患者Scr、Cys-C、hs-CRP水平比较差异无统计学意义(P>0.05)，术后第1天A组患者Cys-C、hs-CRP、Scr水平均显著低于B组(P<0.05)。术后A组有1例(1.85%)患者出现造影剂肾病，B组有4例(8.00%)患者出现造影剂肾病，差异有高度统计学意义(P<0.01)。经过Logistic回归分析显示，年龄、术前Cys-C、术前hs-CRP、高血压、糖尿病为造影剂肾病发生的危险因素。结论阿托伐他汀钙早期干预对经皮冠状动脉介入术后患者的肾功能具有保护作用；年龄、术前Cys-C、hs-CRP、高血压、糖尿病等为造影剂肾病发生的独立危险因素。
목적：연구강화아탁벌타정개치료대경피관상동맥개입술후조영제신병적간예작용，병탐토기작용궤제급기발생적상관인소。방법입선104례관심병환자，근거위술기타정치료방안적불동，장기분위강화타정치료조(A조，54례)、상규타정치료조(B조，50례)，소유환자경피관상동맥개입치료술전급술후1 d균검측초민C반응단백(hs-CRP)、광억소C(Cys-C)화혈기항(Scr)수평。결과술전량조환자Scr、Cys-C、hs-CRP수평비교차이무통계학의의(P>0.05)，술후제1천A조환자Cys-C、hs-CRP、Scr수평균현저저우B조(P<0.05)。술후A조유1례(1.85%)환자출현조영제신병，B조유4례(8.00%)환자출현조영제신병，차이유고도통계학의의(P<0.01)。경과Logistic회귀분석현시，년령、술전Cys-C、술전hs-CRP、고혈압、당뇨병위조영제신병발생적위험인소。결론아탁벌타정개조기간예대경피관상동맥개입술후환자적신공능구유보호작용；년령、술전Cys-C、hs-CRP、고혈압、당뇨병등위조영제신병발생적독립위험인소。
Objective To explore the effect of high-dose Atorvastatin Calcium in preventing radiographic contrast nephropathy after percutaneous coronary intervention and to discuss its mechanism and related risk factors. Methods One hundred and four cases of patients with coronary heart disease were selected, according to the differences of statins therapeutic regimen in perioperative period, they were divided into intensive statin group (group A, n = 54) and con-ventional statin group (group B, n=50). The serum creatinine (Scr), cystain C (Cys-C), high sensitivity C-reactive pro-tein (hs-CRP) of all patients were respectively calculated before percutaneous coronary intervention and one day after percutaneous coronary intervention. Results ①Before operation, the differences of Scr, Cys-C and hs-CRP between two groups were not statistically significant (P> 0.05). On the first day after operation, the levels of Cys-C, hs-CRP, and Scr of group A were significantly lower than those of group B (P< 0.05). After operation, there was one patient (1.85%) with contrast induced nephropathy in group A, 4 patients (8.00%) with contrast induced nephropathy in group B, the difference was statistically significant (P < 0.01). Logistic analysis showed that age, preoperative Cys-C, hs-CRP, hypertension, diabetes were the risk factors of contrast induced nephropathy. Conclusion Early intervention of Atorvastatin Calcium has a protective effect on renal function of patients with percutaneous coronary intervention. Age, preoperative Cys-C, hs-CRP, hypertension and diabetes are the independent risk factors for radiographic contrast nephropathy.