Li Hong, Li Ximing, Ma Hongjun, Wang Yiran, Fu Naikuan, Jin Dongxia, Cong Hongliang
Graduate School, Tianjin Medical University, Tianjin 300051, China ; Department of Geriatrics, The First Hospital of Qinhuangdao, Qinhuangdao 066000, China.
Department of Cardiology, Tianjin Chest Hospital, Tianjin Medical University, Xi'an Road No. 93, Heping District, Tianjin, 300051, China.
ScientificWorldJournal. 2014 Jan 29;2014:565367. doi: 10.1155/2014/565367. eCollection 2014.
Uric acid has ever been considered as one of contrast induced acute kidney injury's risk factors. Atorvastatin and probucol can both improve contrast induced acute kidney injury separately. This prospective study is to assess their effect on reducing serum uric acid level and contrast induced acute kidney injury during perioperative period of interventional procedure. On the basis of different doses of atorvastatin and probucol, 208 cases admitted for coronary angiography or percutaneous coronary intervention were randomly classified into standard combined group (S-C group), intensive combined group (I-C group), and intensive atorvastatin group (I-A group). Patients' blood urea nitrogen, serum creatinine, and serum uric acid were measured and estimated glomerular filtration rate was evaluated 24 hours before and after the procedure. After procedure, blood urea nitrogen in all the three groups decreased; Scr of S-C group and I-A group increased significantly, while estimated glomerular filtration decreased in the S-C group (P < 0.05); serum uric acid in S-C group and I-C group decreased significantly (P < 0.05). Combination treatment of atorvastatin and probucol before intervention could reduce perioperative serum uric acid level; meanwhile, the intensive combined treatment can improve the contrast induced acute kidney injury. The result was the same for hypertensive patients.
尿酸曾被认为是对比剂诱导的急性肾损伤的危险因素之一。阿托伐他汀和普罗布考均可分别改善对比剂诱导的急性肾损伤。本前瞻性研究旨在评估它们在介入手术围手术期对降低血清尿酸水平及对比剂诱导的急性肾损伤的作用。根据阿托伐他汀和普罗布考的不同剂量,将208例因冠状动脉造影或经皮冠状动脉介入治疗入院的患者随机分为标准联合组(S-C组)、强化联合组(I-C组)和强化阿托伐他汀组(I-A组)。在手术前后24小时测量患者的血尿素氮、血清肌酐和血清尿酸,并评估估算肾小球滤过率。术后,三组患者的血尿素氮均下降;S-C组和I-A组的Scr显著升高,而S-C组的估算肾小球滤过率下降(P<0.05);S-C组和I-C组的血清尿酸显著下降(P<0.05)。干预前阿托伐他汀和普罗布考联合治疗可降低围手术期血清尿酸水平;同时,强化联合治疗可改善对比剂诱导的急性肾损伤。高血压患者的结果相同。