摘要
目的探讨不同剂量阿托伐他汀对PCI术后发生造影剂肾病(CIN)的影响,以及中性粒细胞明胶酶相关载脂蛋白(NGAL)对PCI术后发生CIN的早期诊断意义。方法随机选取我院心内科收治的PCI患者212例,随机分为高剂量他汀治疗组(A组)108例,常规剂量他汀治疗组(B组)104例,均完成冠状动脉造影及PCI,检测2组术前及术后4、24、48和72h血肌酐、尿NGAL水平,采用ROC曲线分析NGAL的价值。结果 A组术后CIN发生率明显低于B组(5.6%vs 18.3%,P=0.012)。2组术后4、24、48和72h尿NGAL水平较术前升高,于72h达峰值,且B组较A组升高更明显(P<0.05)。ROC曲线分析显示,术后4、24、48和72h尿NGAL的ROC曲线下面积分别为0.917、0.919、0.928、0.953,诊断CIN的敏感性为92.10%,特异性为100.00%。结论高剂量阿托伐他汀可能减少CIN的发生,尿NGAL较血肌酐更早反映PCI术后肾功能的变化,可作为CIN的早期预测指标。
Objective To study the effect of different atorvastatin doses on contrast-induced nephropathy（CIN）and the role of neutrophil gelatinase-associated lipocalin（NGAL）in early diagnosis of CIN after PCI.Methods Two hundred and twelve patients admitted to our hospital for PCI from June 2015 to January 2017 were divided into high atorvastatin dose treatment group as group A（n=108）and conventional atorvastatin dose treatment group as group B（n=104）.They underwent coronary arteriography and PCI.Their serum creatinine and urinary NGAL levels were measured before and at 4,24,48,72 hrespectively after coronary arteriography and PCI.The role of urinary NGAL level in early diagnosis of CIN was analyzed according to its ROC curve.Results CIN occurred in 6 patients of group A and in 19 patients of group B with an incidence of 5.6%and 18.3% respectively（P=0.012）.The urinary NGAL level was significantly higher in two groups at 4,24,48,72 hrespectively after coronary arteriography and PCI than before coronary arteriography and PCI,reached its peak at 72 h,and was significantly higher in group B than in group A（P〈0.05）.The area under the ROC curve was 0.917,0.919,0.928,0.953 respectively at 4,24,48,72 hafter coronary arteriography and PCI.The sensitivity and specificity of urinary NGAL in early diagnosis of CIN were 92.10%and 100.00%respectively.Conclusion High atorvastatin dose treatment can reduce the occurrence of CIN.Urinary NGAL level can indicate the change of renal function earlier than serum creatinine level after PCI,and can thus be used as an early predictor of CIN.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第1期32-36,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
南京医科大学科技发展基金重点项目(2014NJMUZD024)
关键词
降血脂药
肾病
造影剂
冠状血管造影术
载脂蛋白类
antilipemic agents
nephrosis
contrast media
coronary angiography
apolipoproteins
