论文部分内容阅读
目的:研究阿托伐他汀对冠心病患者行冠状动脉造影术(CAG)后超敏C反应蛋白(hsCRP)的影响及对肾功能的保护作用。方法:将行CAG确诊的84例冠心病患者随机分为治疗组(43例)或对照组(41例),治疗组于CAG前2~3 d始每晚顿服阿托伐他汀20 mg,对照组CAG前未服用阿托伐他汀及其他调脂类药。所有患者分别于CAG前,术后24 h、48 h测定血肌酐(Cr)及尿素氮(BUN);留尿标本检测尿α1-微球蛋白(α1-MG)、尿转铁蛋白(TRF)、尿微量白蛋白(mALB);测血浆胱抑素C(Cys C)、hsCRP,并分别计算出肌酐清除率(Ccr)和肾小球滤过率(GFR)。结果:①对照组:与CAG前相比,CAG后24 hα1-MG、TRF、mALB、Cys C及hsCRP均有显著升高(P<0.01);与CAG后24 h比较,48 hα1-MG、TRF、mALB、Cys C均有显著降低(P<0.01),但α1-MG、Cys C仍高于CAG前水平(P<0.01),而TRF、mALB已恢复到CAG前水平(P>0.05);CAG后48 hhsCRP与CAG前相比无明显变化(P>0.05)。②治疗组:与CAG前比较,CAG后24 h、48 hα1-MG、TRF、mALB、Cys C均无明显变化(P>0.05);CAG后24 h hsCRP显著升高(P<0.01);CAG后48 h hsCRP与CAG前比无明显变化(P>0.05)。③与治疗组相比较:对照组CAG后24 hα1-MG、TRF、mALB、Cys C及hsCRP均显著升高(P<0.01);CAG后48 h Cys C、α1-MG及hsCRP仍显著升高(P<0.01),但TRF、mALB均差异无统计学意义(P>0.05)。2组CAG前、术后BUN、Cr、Ccr均无明显变化(P>0.05)。结论:小剂量造影剂可造成冠心病患者CAG后出现hsCRP、CysC升高及一过性微量蛋白尿,CAG前2~3 d给服阿托伐他汀,具有改善的作用。
Objective: To investigate the effect of atorvastatin on hsCRP in coronary artery disease patients after coronary angiography (CAG) and its protective effect on renal function. Methods: Eighty-four patients with coronary artery disease confirmed by CAG were randomly divided into treatment group (n = 43) and control group (n = 41). Atorvastatin 20 mg, The control group did not take atorvastatin and other lipid-lowering drugs before CAG. Serum creatinine (Cr) and blood urea nitrogen (BUN) were measured before and 24 h and 48 h after CAG in all the patients. Urinary specimens were collected for urinary α1-microglobulin (α1-MG), urinary transferrin (TRF) , Urine microalbumin (mALB); measured serum cystatin C (Cys C), hsCRP, and creatinine clearance (Ccr) and glomerular filtration rate (GFR) were calculated. Results: ① In the control group, the levels of α1-MG, TRF, mALB, Cys C and hsCRP at 24 h after CAG were significantly higher than those before CAG (P <0.01) TRF, mALB and Cys C were significantly lower than those before CAG (P <0.01), but α1-MG and Cys C were still higher than those before CAG (P <0.01) ; 48 h hsCRP after CAG had no significant change compared with that before CAG (P> 0.05). ② In the treatment group, there was no significant change in 48 hα1-MG, TRF, mALB and Cys C at 24 h after CAG (P> 0.05), but significantly higher at 24 h after CAG (P <0.01) After 48 h hsCRP and CAG no significant change (P> 0.05). ③Compared with the treatment group, the levels ofα1-MG, TRF, mALB, Cys C and hsCRP were significantly increased at 24 h after CAG in control group (P <0.01); Cys C, α1-MG and hsCRP at 48 h after CAG were still significantly increased (P <0.01), but there was no significant difference between TRF and mALB (P> 0.05). There were no significant changes in BUN, Cr and Ccr between the two groups before and after CAG (P> 0.05). CONCLUSIONS: Small doses of contrast medium can cause hsCRP, elevated CysC and transient microalbuminuria after CAG in patients with coronary heart disease, and atorvastatin can be given 2 to 3 days before CAG, which has an improved effect.