早期强化瑞舒伐他汀治疗对急性冠状动脉综合征患者经皮冠状动脉介入术后心肾功能的影响

被引：15

作者：

邹筱冬

吴同果

崔进

黄丽萍

机构：

[1] 广东省广州市红十字会医院心血管内科

来源：

广西医学 | 2014年 / 36卷 / 06期

关键词：

急性冠状动脉综合征; 瑞舒伐他汀; 经皮冠状动脉介入术; 心肌灌注; 对比剂肾病;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的探讨早期强化瑞舒伐他汀治疗对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后心肾功能的影响。方法 ACS患者100例,随机分为早期瑞舒伐他汀标准剂量组(标准组)和强化治疗组(强化组),每组50例,两组均按常规方法行PCI,并于术前7 d开始服用瑞舒伐他汀,标准组服用10 mg/d,强化组20 mg/d。观察两组患者手术前后心肌梗死溶栓(TIMI)血流、TIMI心肌灌注分级;观察手术前后血高敏C反应蛋白(hs-CRP)、P选择素、细胞间黏附分子1(ICAM-1)、血肌酐、肌酐清除率(Ccr)水平。结果两组患者均顺利完成手术。术后强化组TIMI血流改善好于标准组(P<0.05),术后即刻校正的TIMI帧数计数明显低于标准组(P<0.01)。两组患者术后血清hs-CRP、P选择素和ICAM-1表达水平均上升,但强化组各项指标升高水平低于标准组(P<0.05)。强化组术后24 h、48 h血肌酐水平低于标准组(P<0.05),肌酐清除率高于标准组(P<0.01),对比剂肾病(CIN)发生率低于标准组(P<0.05)。结论早期强化瑞舒伐他汀治疗可改善ACS患者PCI术后心肌灌注,降低无复流、炎症反应的发生,并且加快肾功能恢复,降低CIN发病率,从而起到更有效保护心肾的功能。

引用

页码：760 / 763

页数：4

共 13 条

[1]

Relation between K469E gene polymorphism of ICAM-1 and recurrence of ACS and cardiovascular mortality[J]. Ling-Zhi Liu,En-Ping Wu,Heng-Liang Liu.Asian Pacific Journal of Tropical Medicine. 2013(11)

[2] 负荷量他汀对急性冠脉综合征择期经皮冠脉介入治疗术后细胞凋亡及心肌损伤和临床事件的影响 [J].

朱记法 ;

马虹 ;

李怡 .

中山大学学报(医学科学版), 2011, 32 (01) :67-70+80

[3]

短期大剂量他汀对冠脉支架术后对比剂肾病预防效果的荟萃分析[D]. 姜波.山东大学. 2013

[4] The role of soluble P selectin in the diagnosis of venous thromboembolism [J].

Antonopoulos, Constantine N. ;

Sfyroeras, George S. ;

Kakisis, John D. ;

Moulakakis, Konstantinos G. ;

Liapis, Christos D. .

THROMBOSIS RESEARCH, 2014, 133 (01) :17-24

[5]

Preventive effect of statin pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty: Propensity score analysis from a multicenter registry[J] . Tomoya Hoshi,Akira Sato,Yuki Kakefuda,Tomohiko Harunari,Hiroaki Watabe,Eiji Ojima,Daigo Hiraya,Daisuke Abe,Hidetaka Nishina,Noriyuki Takeyasu,Yuichi Noguchi,Kazutaka Aonuma.International Journal of Cardiology . 2013

[6] Combined Cathepsin S and hs-CRP predicting inflammation of Abdominal Aortic Aneurysm [J].

Qin, Yanwen ;

Yang, Yaoguo ;

Liu, Rong ;

Cao, Xu ;

Liu, Ou ;

Liu, Jing ;

Wang, Miao ;

Yang, Ya ;

Chen, Zhong ;

Zhang, Hongjia ;

Du, Jie .

CLINICAL BIOCHEMISTRY, 2013, 46 (12) :1026-1029

[7]

Effect of seven-day atorvastatin pretreatment on the incidence of periprocedural myocardial infarction following percutaneous coronary intervention in patients receiving long-term statin therapy. A randomized study[J] . David Zemánek,Marian Branny,Lucie Martinkovi?ová,Petr Hájek,Martin Maly,David Tesa?,Pavol Toma?ov,Josef Veselka.International Journal of Cardiology . 2013

[8]

Mortality of patients with ST-segment elevation myocardial infarction and cardiogenic shock treated by PCI is correlated to the infarct-related artery – Results from the PL-ACS Registry[J] . Przemys?aw Trzeciak,Marek Gierlotka,Mariusz G?sior,Andrzej Lekston,Krzysztof Wilczek,Grzegorz S?onka,Zbigniew Kalarus,Marian Zembala,Bartosz Hudzik,Lech Poloński.International Journal of Cardiology . 2013 (1)

[9]

Relationship between serum antibody titres to Porphyromonas gingivalis and hs-CRP levels as inflammatory markers of periodontitis[J] . Hirotaka Miyashita,Tomoyuki Honda,Tomoki Maekawa,Naoki Takahashi,Yukari Aoki,Takako Nakajima,Koichi Tabeta,Kazuhisa Yamazaki.Archives of Oral Biology . 2011 (6)

[10]

QUANTIFICATION AND IMPACT OF UNTREATED CORONARY ARTERY DISEASE AFTER PCI: THE RESIDUAL SYNTAX SCORE[J] . Philippe Genereux,Tullio Palmerini,Adriano Caixeta,Gregg Rosner,Philip Green,Ovidiu Dressler,George Dangas,Roxana Mehran,Gregg Stone.Journal of the American College of Cardiology . 2012 (13)

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