摘要
目的探讨前列地尔联合阿托伐他汀对老年急性冠脉综合征(ACS)合并轻中度肾病患者冠状动脉造影术后造影剂肾病(CIN)的影响。方法将200例择期行冠状动脉造影(CAG)检查的老年ACS合并轻中度肾病(30%<肾小球滤过率<90%)患者,按照随机数字表法分为治疗组及对照组各100例,术后均给予水化治疗。对照组给予阿托伐他汀(20 mg/d)治疗,治疗组在给予他汀治疗的基础上加用前列地尔(20μg/d)治疗,观察两组患者CAG术前、术后第2天、第7天的血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(e GFR)水平,并对比两组术后院内不良事件的发生率。结果术后第2天与术前对比,两组Scr、BUN显著升高,e GFR显著下降,差异有统计学意义(P<0.05);治疗组与对照组相比,Scr、BUN显著降低,e GFR显著增高,差异有统计学意义(P<0.05)。术后第7天,两组与术前对比,Scr、BUN、e GFR差异无统计学意义(P>0.05);治疗组与对照组对比,Scr、BUN、e GFR差异无统计学意义(P>0.05)。两组患者术后院内不良事件发生率对比,治疗组造影剂肾病发生率低于对照组(11%比16%)、需要肾脏替代治疗(0%比5%)、死亡率(5%比6%)、急性心力衰竭(1%比3%)、再发心绞痛(7%比12%)、快速心律失常(7%比7%),差异无统计学意义(P>0.05)。结论前列地尔联合阿托伐他汀治疗老年ACS合并轻度肾病患者CAG术后造影剂肾病的发生有预防保护作用。
Objective To investigate the effect of alprostadil combined with atorvastatin on contrast induced nephropathy（CIN） in elderly patients with acute coronary syndrome（ACS） with mild to moderate renal disease after coronary angiography. Methods 200 patients undergoing coronary angiography （CAG） examination of the elderly ACS patients with mild to moderate nephropathv （30% 〈 eGFR 〈 90% ） were randomly divided into treatment groun and con- trol group 100 cases, were treated with water treatment after operation. The control group was given atorvastatin （20 mg/d） treatment, treatment group on the basis of statin therapy combined with alprostadil（20 μg/d） treatment,observe two groups of patients before and after CAG for second days, seventh days of serum creatinine （ Scr）, urea nitrogen （BUN）, glomerular filtration rate（eGFR） level the incidence rate, and compare the two groups in postoperative adverse events. Results At the second days after the CAG, Scr and BUN were significantly increased, eGFR decreased signifi- cantly, the difference was statistically significant （ P 〈 O. 05 ）, the treatment group compared with the control group, Scr and BUN decreased, eGFR increased significantly, the difference was statistically significant（P 〈 O. 05）. At the seventh days after operation, Scr, BUN and eGFR were not statistically significant （ P 〉 O. 05 ）. The difference of Scr, BUN and eGFR between the treatment group and the control group was not statistically significant（P 〉 O. 05 ）. Two groups of pa- tients in postoperative incidence of adverse events compared to treatment group, the incidence of contrast induced ne- phropathy was lower than that of control group（ 11% VS. 16% ） ,need for renal replacement therapy （0% VS. 5% ）, mortality （5% VS. 6% ） ,acute heart failure （1% VS. 3% ） ,recurrent angina （7% VS. 12% ） ,fast fast arrhythmia （7% VS. 7% ） , there was no statistically significant difference （P 〉 0.05 ）. Conclusion Alprostadil combined with atorvastatin treatment of elderly patients with mild to moderate ACS nephropathy can prevent the occurrence of contrast induced nephropathy.
出处
《中国临床保健杂志》
CAS
2017年第4期353-356,共4页
Chinese Journal of Clinical Healthcare
基金
国家自然科学基金(81260043)
作者简介
王萍，主治医师，Email：wangpingqionghai@163．com
