| 摘要: |
| 目的探讨两种常规剂量他汀治疗对急性冠状动脉综合征（ACS）合并肾功能不全患者肾功能的影响。方法将136例ACS合并肾功能不全患者采用单双号随机分为阿托伐他汀组（阿托伐他汀20mg/d）68例和瑞舒伐他汀组（瑞舒伐他汀10mg/d）68例，分别于治疗前、治疗后1个月观察血脂、肝功能及肾功能指标变化情况，临床随访12个月，评价两组心血管死亡、非心血管死亡、因心血管再住院和因肾脏病住院情况。结果与治疗前相比，两组患者TC、TG、LDL-C水平显著下降（均P＜0.05），HDL-C、ALT、AST水平显著上升（均P＜0.05）；治疗后两组间TC、TG、LDL-C、HDL-C水平差异无统计学意义（均P＞0.05）。治疗后阿托伐他汀组血肌酐（Cr）水平明显降低，肾小球滤过率（eGFR）水平明显升高（均P＜0.05）；瑞舒伐他汀组Cr、eGFR水平差异无统计学意义（P＞0.05）。结论两种常规剂量他汀治疗ACS合并肾功能不全患者，疗效和安全性相似，都具有保护肾脏的作用，但阿托伐他汀疗效更优。 |
| 关键词: 急性冠状动脉综合征 他汀 肾功能 肾小球滤过率 |
| DOI：10.12056/j.issn.1006-2785.2018.40.11.2017-2638 |
| 分类号: |
| 基金项目:杭州市卫生科技重大项目（2013ZD021）；杭州市卫生系统课题（2014B24） |
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| Effects of standard-dose statins on renal function in patients with acute coronary syndrome and chronic kidney disease |
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Hangzhou First People's Hospital Affiliated to Nangjing Medical University
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| Abstract: |
| Objective To investigate the effects of standard-dose statins on renal function in patients with acute coronary
syndrome (ACS) and chronic kidney disease (CKD). Methods One hundred and thirty six ACS patients with CKD admitted in Hangzhou First People′ s Hospital from July 2010 to September 2016 were enrolled consecutively into this study. The patients were randomly assigned to receive oral atorvastatin 20mg per night for one month (n=68,), or oral rosuvastatin10mg per night for one month (n=68). The biochemical indexes were measured on the admission and one month after treatment. The patients were followed up for 1 year. Results After one-month treatment, the levels of total triglyceride (TG), total cholesterol (TC) , low density lipoprotein cholesterol (LDL-C) were significantly decreased, whereas the levels of high density lipoprotein cholesterol (HDL-C), ALT and AST were significantly increased in both groups (all P＜0.05). Glomerular filtration rates (GFRs) and CR were significantly improved after treatment in atorvastatin group (P＜ 0.05), while those indicators in rosuvastatin group were not significantly changed after treatment (P＜0.05)．There were no significant differences in TC, TG, LDL-C and HDL-C after treatment between rosuvastatin and atorvarstatin group (P ＞0.05)．Adverse clinical events were rare in both groups, and no significant difference between two groups (P ＞0.05). Conclusion The standard-dose atorvastatin or rosuvastatincan improve the eGFR, while
the renal protective effect of atorvastatin is more predominant in ACS patients with CKD. |
| Key words: Acute coronary syndrome Statin Renal Function Glomerular filtration rate |
