不同他汀序贯治疗对糖尿病患者急诊PCI术后对比剂肾病的干预效应

发布时间：2018-05-12 16:40

本文选题：他汀 + 急性心肌梗死　；参考：《临床心血管病杂志》2016年04期

【摘要】：目的:对比不同他汀大剂量序贯治疗对老年(年龄60岁)糖尿病并急性心肌梗死(AMI)患者急诊经桡动脉冠状动脉内介入治疗术(PCI)后对比剂相关肾病(CIN)的保护作用。方法:将急诊PCI术的老年AMI合并糖尿病患者90例,随机分为大剂量阿托伐他汀组(对照组)及大剂量瑞舒伐他汀组(实验组)。在水化治疗的基础上,实验组入院后即刻口服瑞舒伐他汀20mg,急诊PCI术后3d内每日口服瑞舒伐他汀20mg;对照组在入院后即刻口服阿托伐他汀80mg,急诊PCI术后3d内每日口服40mg。分别测定2组患者术后24h、72h的血清尿素氮(BUN)、血清肌酐(Scr)、内生肌酐清除率(Ccr)以及CIN的发生率。结果:急诊PCI术后24h、72h实验组BUN、Scr增加值和增加百分比,Ccr下降值和下降比例以CIN的发生率与对照组无明显差别。结论:大剂量瑞舒伐他汀和阿托伐他汀序贯治疗对老年糖尿病患者急诊经桡动脉PCI术后CIN的发生具有类似的保护作用。
[Abstract]:Aim: to compare the protective effects of high dose sequential treatment with different statins on CINs in elderly patients with diabetes mellitus (60 years old) with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods: ninety elderly patients with AMI complicated with diabetes mellitus undergoing PCI were randomly divided into two groups: high dose Atto vastatin group (control group) and high dose rosuvastatin group (experimental group). On the basis of hydration therapy, the experimental group was given 20 mg of resuvastatin immediately after admission and 20 mg of resuvastatin daily within 3 days after emergency PCI, while the control group took 80 mg of Atto vastatin immediately after admission and 40 mg per day of emergency PCI 3 days after operation. The serum urea nitrogen bun, creatinine (creatinine), creatinine clearance rate (creatinine clearance rate) and the incidence of CIN were measured at 24 hours and 72 hours after operation in both groups. Results: there was no significant difference between the incidence rate of CIN and the increase and percentage of CCR in the experimental group. Conclusion: Risuvastatin and Atto vastatin sequential therapy have a similar protective effect on the occurrence of CIN after emergency tranradial artery PCI in elderly patients with diabetes.
【作者单位】：武汉市普爱医院心内科;
【分类号】：R587.2;R542.22

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