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目的研究他汀预处理联合前列地尔对造影剂肾病的预防作用,指导临床用药。方法顺序选取2015年1月~2016年1月就诊于潍坊医学院附属医院心内科诊断为非ST段抬高型急性冠脉综合征(NSTEACS),且择期冠脉造影(CAG)检查者60例。将患者随机分为对照组及试验组各30例,对照组应用瑞舒伐他汀(10mg/d)治疗,试验组在他汀预处理基础上,给予前列地尔(100μg/d)治疗。术后均给予水化治疗。分别于CAG术前,术后2d,术后7d测定血清肌酐、尿素及内生肌酐清除率(Ccr)。结果术后2d试验组与对照组相比,肌酐、尿素水平显著降低,Ccr水平显著增高,差异有统计学意义(P<0.05)。术后7d与术前比较,对照组及试验组肌酐、尿素及Ccr差异均无统计学意义(P>0.05)。结论他汀预处理联合前列地尔对造影剂肾病有更好的预防作用,可能成为预防造影剂肾病的新方法。
Objective To study the preventive effect of statin pretreatment combined with alprostadil on contrast agent nephropathy and to guide the clinical medication. METHODS: From January 2015 to January 2016, 60 patients with non ST-segment elevation acute coronary syndrome (NSTEACS) diagnosed in Department of Cardiology, Weifang Medical College Affiliated Hospital, and 60 patients undergoing selective coronary angiography (CAG) . The patients were randomly divided into control group and trial group, 30 cases in each group. The control group was treated with rosuvastatin (10 mg / d), and the treatment group was treated with alprostadil (100 μg / d) on the basis of statin pretreatment. Postoperative hydration therapy. Serum creatinine, urea and endogenous creatinine clearance (Ccr) were measured before operation, 2 days after operation and 7 days after operation respectively. Results Compared with the control group, the level of creatinine and urea and the level of Ccr in the experimental group were significantly lower than those in the control group on the 2nd postoperative day. The difference was statistically significant (P <0.05). There was no significant difference in creatinine, urea and Ccr between the control group and the experimental group at 7 days after operation (P> 0.05). Conclusions Statin pretreatment combined with alprostadil has a better preventive effect on contrast agent nephropathy and may be a new method to prevent contrast agent nephropathy.