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不同剂量阿托伐他汀对 CT 灌注后对比剂诱导急性肾损伤的预防作用。

The preventive effects of different doses of atorvastatin on contrast-induced acute kidney injury after CT perfusion.

机构信息

Imaging department of Tianjin Huanhu hospital, Tianjin, China.

出版信息

J Clin Lab Anal. 2022 Jul;36(7):e24386. doi: 10.1002/jcla.24386. Epub 2022 May 17.

Abstract

BACKGROUND

Contrast-induced acute kidney injury (CI-AKI) is a severe complication among patients receiving intravascular contrast media. The purpose of this study was to investigate the preventive effects of pretreatment of atorvastatin at intensive doses on CI-AKI after computed tomography (CT) perfusion.

METHODS

The levels of serum creatinine (SCR), blood urea nitrogen (BUN), Cystatin C (CysC), estimated glomerular filtration rate (eGFR), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in patients were compared between the observation group receiving 40 mg/kg atorvastatin and the control group receiving 20 mg/kg atorvastatin before and 72 h after CT examination. In addition, the incidence of CI-AKI was recorded.

RESULTS

Compared with the control group, the incidence of renal injury in the observation group was significantly reduced, from 8% to 2% (χ  = 6.62, p = 0.010). In addition, there was no notable difference in the levels of Scr, BUN, CysC, hs-CRP, and IL-6 before CT examination between two groups (p > 0.05). The levels of SCR, BUN, CysC, hs-CRP, and IL-6 were increased, while the levels of eGFR were decreased in the control group at 72 h after CT examination (p < 0.05). At 72 h after CT enhancement, the levels of BUN, CysC, and hs-CRP were prominently increased in the observation group (p < 0.05), while SCR, eGFR, and IL-6 did not change (p > 0.05). Compared with the control group, the levels of SCR, BUN, CysC, eGFR, hs-CRP, and IL-6 in the observation group were significantly decreased at 72 h after CT examination (p < 0.05).

CONCLUSION

Intensive dose of atorvastatin pretreatment can prevent CI-AKI undergoing CT perfusion through lowering inflammation as well as renal function indexes SCR, CysC, BUN, and eGFR.

摘要

背景

对比剂诱导的急性肾损伤(CI-AKI)是接受血管内对比剂的患者的严重并发症。本研究的目的是探讨强化剂量阿托伐他汀预处理对 CT 灌注后 CI-AKI 的预防作用。

方法

比较 CT 检查前后观察组(阿托伐他汀 40mg/kg)和对照组(阿托伐他汀 20mg/kg)患者血清肌酐(SCR)、血尿素氮(BUN)、胱抑素 C(CysC)、估算肾小球滤过率(eGFR)、高敏 C 反应蛋白(hs-CRP)和白细胞介素 6(IL-6)水平。同时记录 CI-AKI 的发生率。

结果

与对照组相比,观察组肾损伤发生率明显降低,从 8%降至 2%(χ²=6.62,p=0.010)。此外,两组 CT 检查前 Scr、BUN、CysC、hs-CRP 和 IL-6 水平无明显差异(p>0.05)。CT 检查后 72h 时,对照组 SCR、BUN、CysC、hs-CRP 和 IL-6 水平升高,eGFR 水平降低(p<0.05)。CT 增强后 72h,观察组 BUN、CysC 和 hs-CRP 水平明显升高(p<0.05),SCR、eGFR 和 IL-6 水平无变化(p>0.05)。与对照组相比,观察组 CT 检查后 72h 的 SCR、BUN、CysC、eGFR、hs-CRP 和 IL-6 水平明显降低(p<0.05)。

结论

强化剂量阿托伐他汀预处理可通过降低炎症及 SCR、CysC、BUN 和 eGFR 等肾功能指标来预防 CT 灌注后发生 CI-AKI。

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