本文選題：卒中　切入點：腦缺血　出處：《中國全科醫(yī)學》2017年07期 　論文類型：期刊論文

【摘要】：目的探討不同劑量阿托伐他汀對缺血性腦卒中介入診療術后對比劑腎損害的預防作用。方法選取2012年8月—2014年12月在首都醫(yī)科大學附屬北京世紀壇醫(yī)院住院治療的缺血性腦卒中患者194例,根據(jù)隨機數(shù)字表法分為高劑量他汀組(n=98)和低劑量他汀組(n=96)。兩組均在使用對比劑前開始口服阿托伐他汀,其中高劑量他汀組患者給予阿托伐他汀40 mg/d;低劑量他汀組給予阿托伐他汀20 mg/d。比較兩組術前和術后24、48 h血肌酐(SCr)、血胱抑素C(Cys C)水平及術后SCr峰值、SCr增高值(△SCr)、對比劑腎病(CIN)發(fā)生率、不良反應發(fā)生情況等。結果兩組男性比例、年齡≥70歲比例、高血壓發(fā)生率、糖尿病發(fā)生率、血管緊張素轉換酶抑制劑(ACEI)/血管緊張素受體拮抗劑(ARB)使用率、對比劑用量≥200 ml比例間差異均無統(tǒng)計學意義(P0.05)。兩組SCr水平間差異無統(tǒng)計學意義(P0.05),不同時間點SCr水平間差異有統(tǒng)計學意義(P0.05),治療方法和時間在SCr水平上存在交互作用(P0.05)。兩組Cys C水平間差異有統(tǒng)計學意義(P0.05),不同時間點Cys C水平間差異有統(tǒng)計學意義(P0.05),治療方法和時間在Cys C水平上存在交互作用(P0.05)。高劑量他汀組術后SCr峰值、△SCr均低于低劑量他汀組,差異有統(tǒng)計學意義(P0.05)。高劑量他汀組CIN發(fā)生率低于低劑量他汀組,差異有統(tǒng)計學意義(P0.05)。兩組術后7 d復查血常規(guī)、血生化和凝血功能均未見明顯異常。結論高劑量阿托伐他汀對腦血管介入診療術后對比劑腎損害有一定的預防保護作用。
[Abstract]:Objective to investigate the preventive effect of different doses of Atto vastatin on renal damage after interventional diagnosis and treatment of ischemic stroke. Methods from August 2012 to December 2014, the patients were hospitalized at Beijing Shijitan Hospital affiliated to Capital Medical University. 194 patients with ischemic stroke, According to the random number table method, they were divided into high dose statin group and low dose statins group respectively. Both groups were given Atto vastatin orally before using contrast agent. The patients in the high dose statins group were treated with Atto vastatin 40 mg / d, and the low dose statins group were given Atto vastatin 20 mg / d. The levels of serum creatinine, cystatin Cys C and the peak value of SCr were compared between the two groups. The incidence of contrast-agent nephropathy (CINs), Results the incidence rate of hypertension, diabetes, angiotensin converting enzyme inhibitor (ACEI) / angiotensin receptor antagonist (ARB) was observed in the two groups. There was no significant difference in the ratio of dosage of contrast agent 鈮，

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