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阿托伐他汀对预防造影剂增强计算机断层扫描期间造影剂诱发的急性肾损伤的作用

[The atorvastatin effects on the prevention of contrast-induced acute kidney injury during computed tomography with contrast media].

作者信息

Vasin A A, Mironova O I, Fomin V V

机构信息

Sechenov First Moscow State Medical University (Sechenov University).

出版信息

Ter Arkh. 2022 Oct 24;94(9):1057-1061. doi: 10.26442/0403660.2022.09.201845.

Abstract

AIM

To assess the role of atorvastatin to the frequency of contrast-induced acute kidney injury (CI-AKI) in patients with cardiovascular diseases (CVD) undergoing computed tomography (CT) with intravenous contrast media.

MATERIALS AND METHODS

One hundred patients with CVD undergoing CT with with intravenous contrast media administration were included in prospective observational study (ClinicalTrials.gov ID NCT04666389). Patients were divided into 3 groups 16 (15.8%) patients receiving atorvastatin at a dose of 80 mg 24 hours and 40 mg before the CT and 40 mg after; 33 (32.7%) patients 40 mg before the CT and 40 mg after; 52 (51.5%) people not receiving statin therapy. The primary endpoint was CI-AKI according to KDIGO criteria: the 25% rise (or 0.5 mg/dl) of serum creatinine from baseline assessed 4872 hours after administration of contrast media. There were 51% of men. The average age was 59.7714.4. The most frequent cardiovascular disease was hypertension 86%.

RESULTS

CI-AKI was diagnosed in 4 (3.96%) patients. At the same time, it was not possible to establish statistically significant relationships (p0.05) between risk factors and the development of CI-AKI. Statins can be a successful way to prevent this complication.

CONCLUSION

Cardiovascular diseases may increase the risk of CI-AKI after computed tomography with intravenous contrast media administration. Therefore, it is recommended to evaluate the serum creatinine concentration in such patients.

摘要

目的

评估阿托伐他汀对接受静脉造影剂计算机断层扫描(CT)的心血管疾病(CVD)患者发生对比剂诱导的急性肾损伤(CI-AKI)频率的作用。

材料与方法

100例接受静脉造影剂CT检查的CVD患者纳入前瞻性观察研究(ClinicalTrials.gov标识符NCT04666389)。患者分为3组:16例(15.8%)患者在CT检查前24小时接受80mg阿托伐他汀,CT检查前和检查后各接受40mg;33例(32.7%)患者在CT检查前和检查后各接受40mg;52例(51.5%)患者未接受他汀类药物治疗。主要终点是根据KDIGO标准诊断的CI-AKI:造影剂给药后48 - 72小时血清肌酐较基线水平升高25%(或0.5mg/dl)。男性占51%。平均年龄为59.7±7.14岁。最常见的心血管疾病是高血压,占86%。

结果

4例(3.96%)患者被诊断为CI-AKI。同时,无法确定危险因素与CI-AKI发生之间的统计学显著关系(p>0.05)。他汀类药物可能是预防这种并发症的成功方法。

结论

心血管疾病可能增加静脉注射造影剂后CT检查发生CI-AKI的风险。因此,建议评估此类患者的血清肌酐浓度。

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