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[目的]采用前瞻性随机对照试验,观察较大剂量阿托伐他汀预防老年人对比剂肾病(contrast-induced nephropathy,CIN)的有效性及安全性。[方法]将110例年龄﹥65岁行冠脉介入诊疗的的患者随机分为普通剂量组(服用阿托伐他汀钙片20mg/d)与高剂量组(服用阿托伐他汀钙片60mg/d),对比2组肾功能变化及CIN的发生率。[结果]使用对比剂后48～72h的高剂量组血肌酐(Scr)显著低于普通剂量组[(86.2±19.7)mmol/L比(99.9±20.80)mmol/L,P=0.001)],估算的肾小球滤过率(eGFR)亦显著高于普通剂量组[(105.3±25.8)ml/min/1.73m2比(88.0±21.2)ml/min/1.73m2,P=0.000)]。高剂量组CIN发生率显著低于普通剂量组(分别为1.8%和12.7%,P=0.030)。[结论]较大剂量的阿托伐他汀(60mg/d)对老年患者CIN的发生可能有更好的预防作用,且较为安全。
[Objective] To observe the effectiveness and safety of higher-dose atorvastatin in the prevention of contrast-induced nephropathy (CIN) in the elderly by a prospective randomized controlled trial. [Methods] A total of 110 patients (> 65 years) undergoing coronary intervention were randomly divided into normal dose group (atorvastatin calcium 20mg / d) and high dose (atorvastatin calcium 60mg / d) Compare the changes of renal function and the incidence of CIN in the two groups. [Results] Serum creatinine (Scr) of high dose group 48 ~ 72h after using contrast agent was significantly lower than that of common dose group [(86.2 ± 19.7) mmol / L, 99.9 ± 20.80 mmol / L, P = 0.001] The estimated glomerular filtration rate (eGFR) was also significantly higher than that of the normal dose group [(105.3 ± 25.8) ml / min / 1.73 m2 vs (88.0 ± 21.2) ml / min / 1.73 m2, P = 0.000). The incidence of CIN in the high-dose group was significantly lower than in the normal dose group (1.8% and 12.7%, respectively, P = 0.030). [Conclusion] A higher dose of atorvastatin (60mg / d) may have a better preventive effect on the occurrence of CIN in elderly patients and is safer.