不同剂量阿托伐他汀对缺血性脑卒中介入诊疗术后对比剂肾损害的预防作用研究

发布时间：2018-03-19 23:34

  本文选题：卒中　切入点：脑缺血　出处：《中国全科医学》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨不同剂量阿托伐他汀对缺血性脑卒中介入诊疗术后对比剂肾损害的预防作用。方法选取2012年8月—2014年12月在首都医科大学附属北京世纪坛医院住院治疗的缺血性脑卒中患者194例,根据随机数字表法分为高剂量他汀组(n=98)和低剂量他汀组(n=96)。两组均在使用对比剂前开始口服阿托伐他汀,其中高剂量他汀组患者给予阿托伐他汀40 mg/d;低剂量他汀组给予阿托伐他汀20 mg/d。比较两组术前和术后24、48 h血肌酐(SCr)、血胱抑素C(Cys C)水平及术后SCr峰值、SCr增高值(△SCr)、对比剂肾病(CIN)发生率、不良反应发生情况等。结果两组男性比例、年龄≥70岁比例、高血压发生率、糖尿病发生率、血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)使用率、对比剂用量≥200 ml比例间差异均无统计学意义(P0.05)。两组SCr水平间差异无统计学意义(P0.05),不同时间点SCr水平间差异有统计学意义(P0.05),治疗方法和时间在SCr水平上存在交互作用(P0.05)。两组Cys C水平间差异有统计学意义(P0.05),不同时间点Cys C水平间差异有统计学意义(P0.05),治疗方法和时间在Cys C水平上存在交互作用(P0.05)。高剂量他汀组术后SCr峰值、△SCr均低于低剂量他汀组,差异有统计学意义(P0.05)。高剂量他汀组CIN发生率低于低剂量他汀组,差异有统计学意义(P0.05)。两组术后7 d复查血常规、血生化和凝血功能均未见明显异常。结论高剂量阿托伐他汀对脑血管介入诊疗术后对比剂肾损害有一定的预防保护作用。
[Abstract]:Objective to investigate the preventive effect of different doses of Atto vastatin on renal damage after interventional diagnosis and treatment of ischemic stroke. Methods from August 2012 to December 2014, the patients were hospitalized at Beijing Shijitan Hospital affiliated to Capital Medical University. 194 patients with ischemic stroke, According to the random number table method, they were divided into high dose statin group and low dose statins group respectively. Both groups were given Atto vastatin orally before using contrast agent. The patients in the high dose statins group were treated with Atto vastatin 40 mg / d, and the low dose statins group were given Atto vastatin 20 mg / d. The levels of serum creatinine, cystatin Cys C and the peak value of SCr were compared between the two groups. The incidence of contrast-agent nephropathy (CINs), Results the incidence rate of hypertension, diabetes, angiotensin converting enzyme inhibitor (ACEI) / angiotensin receptor antagonist (ARB) was observed in the two groups. There was no significant difference in the ratio of dosage of contrast agent 鈮，

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