CAJ | 학술논문

目的：探讨经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）前不同剂量的阿托伐他汀对对比剂诱导急性肾损伤（acute kidney injury，AKI）的影响。方法选取2013年2月至2014年4月于本院肾内科住院的AKI患者100例为研究对象，所有患者均行连续肾脏替代疗法（continuous renal replacement therapy，CRRT）治疗，依据随机数表法将入选患者分为40 mg阿托伐他汀组与20 mg阿托伐他汀组，每组各50例，观察并比较两组患者PCI术后肾功能指标、手术前后中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平及AKI发生情况。结果两组患者尿素氮及尿酸水平比较差异无显著性（P＞0.05），但两组患者血肌酐（Scr）水平与估算肾小球滤过率（eGFR）比较差异具有显著性（P＜0.05）。两组患者术前NGAL水平比较差异无显著性（P＞0.05），术后2小时、48小时40 mg阿托伐他汀组患者NGAL水平较20 mg阿托伐他汀组明显降低（P＜0.05）；40 mg阿托伐他汀组4例（8.0%）患者发生AKI，20 mg阿托伐他汀组10例（20.0%）患者发生AKI，两组比较差异具有显著性（χ2＝6.0020，P＝0.0143）。结论 PCI术前应用40 mg阿托伐他汀能够有效降低AKI的发生率，安全有效，值得临床推广应用。
목적：탐토경피관상동맥개입치료（percutaneous coronary intervention，PCI）전불동제량적아탁벌타정대대비제유도급성신손상（acute kidney injury，AKI）적영향。방법선취2013년2월지2014년4월우본원신내과주원적AKI환자100례위연구대상，소유환자균행련속신장체대요법（continuous renal replacement therapy，CRRT）치료，의거수궤수표법장입선환자분위40 mg아탁벌타정조여20 mg아탁벌타정조，매조각50례，관찰병비교량조환자PCI술후신공능지표、수술전후중성립세포명효매상관지질운재단백（NGAL）수평급AKI발생정황。결과량조환자뇨소담급뇨산수평비교차이무현저성（P＞0.05），단량조환자혈기항（Scr）수평여고산신소구려과솔（eGFR）비교차이구유현저성（P＜0.05）。량조환자술전NGAL수평비교차이무현저성（P＞0.05），술후2소시、48소시40 mg아탁벌타정조환자NGAL수평교20 mg아탁벌타정조명현강저（P＜0.05）；40 mg아탁벌타정조4례（8.0%）환자발생AKI，20 mg아탁벌타정조10례（20.0%）환자발생AKI，량조비교차이구유현저성（χ2＝6.0020，P＝0.0143）。결론 PCI술전응용40 mg아탁벌타정능구유효강저AKI적발생솔，안전유효，치득림상추엄응용。
ObjectiveTo investigate the inlfuences of application of different doses of atorvastatin before percutaneous coronary intervention (percutaneous coronary intervention, PCI) on acute kidney injury (AKI) induced by contrast agent.Method100 patients with AKI in our hospital from February 2013 to April 2014 were selected as the study objects, all patients were underwent continuous renal replacement therapy (continuous renal replacement therapy, CRRT), the enrolled patients were divided into 40 mg atorvastatin group and 20 mg atorvastatin group according to a random number table method, each had 50 cases, the renal function, NGAL and AKI levels before and after the surgery of the two groups were observed and compared.ResultThe differences of blood urea nitrogen and uric acid were not statistically signiifcant (P>0.05), but the differences of serum creatinine (Scr) and estimated glomerular ifltration rate (eGFR) levels were signiifcant (P<0.05). The difference of preoperative NGAL level was not statistically signiifcant (P>0.05), the NGAL levels after 2 hours, 48 hours of patients in 40 mg atorvastatin group was signiifcantly lower than 20 mg atorvastatin group (P<0.05); 40 mg atorvastatin group had 4 cases (8.0%) with AKI, 20 mg atorvastatin group had 10 cases (20.0%) with AKI, the difference was signiifcant (χ2=6.0020,P=0.0143) .ConclusionApplication of 40 mg atorvastatin after PCI can reduce the incidence of AKI, it is safe and effective, worthy of clinical application.