Renal Protection Effect Of Atorvastatin Calcium On Cardiac Insufficiency Patients With Coronary Heart Disease

ObjectiveTo investigate the Renal protection effect of Atorvastatin Calcium on cardiacinsufficiency Patients with coronary heart disease by adding Atorvastatin Calcium onthe base of conventional treatment(including Diuretic drugs, Digoxin, angiotensinconverting enzyme inhibitors or ARB, β-adrenergic block agents, Aspirin, Aspirinetc.)Materials and MethodsAccording to the coronary heart disease diagnostic criteria by ACC and AHA in2005, the diagnosed cardiac insufficiency Patients with coronary heart disease inHeart medicine from May2010to September2011were selected to detect the Bloodlipids (including Triglyceride(TG), Total cholesterol(TC), High-density cholesterol(HDL-C) and Low-density cholesterol (LDL-C)), Blood glucose(GLU) and Renalfunction index(including blood Creatinine(Cr), Urea, Beta2microglobulin(β2MG)and Cystatin c(Cystatin C))，And the Cardiac functions wereassessed and rated according to NYHA Grading criteria. The high Bloodlipids(TC≥6.22mmol/L and(or)LDL-C≥4.14mmol/L and(or)HDL-C<1.04mmol/Land (or) TG≥2.26mmol/L), high Blood glucose (FPG≥7.0mmol/L， or2hPG≥11.1mmol/L in OGTT，or random Plasma glucose≥11.1mmol/L),and the ⅣCardiac functions or Intervention diagnosis and treatment Patients were Excluded.64 cases(males38,femal26and age53-74) were selected to be divided the normal Renalfunction group(32cases)and imnormal Renal function group(32cases) according toGFR index(GFR>80ml/min).Each group were treated by adding Statins(20mg QN)on the base of conventional treatment(including Diuretic drugs, Digoxin, angiotensinconverting enzyme inhibitors or ARB, β-adrenergic block agents, Aspirin, Aspirinetc.). The age, gender, body surface area(BSA) and body mass index(BMI) of eachgroup were balanced. All the follow-up records of patiets were saved. The time offollow-up lasted12months, and the contents of follow-up included Renal functionindex of6months,12months Discharged from hospital and the Cardiac functionsrating.Statistical workAll the data were analysed statistically with SPSS13.0softwareResults1. Among the patients of follow-up, nobody lost to follow-up in normal Renalfunction group. In imnormal Renal function group,3patients(males2,female1) lostto follow-up. The total follow up rate was4.7%.2. Comparison of patients general material. No statistical difference was found inage, gender, BSA, BMI, blood pressure and the Cardiac functions rating betweennormal Renal function group and imnormal Renal function group (p>0.05).Comparison could be carried out.3. The transformation of the Cardiac functions rating after treatment. In normalRenal function group,6months after treatment5cases of Ⅲ Cardiac functionschanged into Ⅱ Cardiac functions,1cases of Ⅲ Cardiac functions into Cardiacfunctions, and9cases of Ⅱ Cardiac functions into Cardiac functions.12monthsafter treatment4cases of Ⅲ Cardiac functions changed into Ⅱ Cardiac functions,and8cases of Ⅱ Cardiac functions into Cardiac functions. In imnormal Renalfunction group,6months after treatment6cases of Ⅲ Cardiac functions changedinto Ⅱ Cardiac functions,1cases of Ⅲ Cardiac functions into Cardiac functions,and8cases of Ⅱ Cardiac functions into Cardiac functions.12months after treatment3cases of Ⅲ Cardiac functions changed into Ⅱ Cardiac functions, and6cases of Ⅱ Cardiac functions into Cardiac functions.4. Comparison of Renal function index before and after treatment.4.1InⅡ-Ⅲ Cardiac functions patients of both normal Renal function group andimnormal Renal function group the blood UREA and β2MG level of6months aftertreatment was a little higher than before treatmen. And In and Ⅱ-Ⅲ Cardiacfunctions patients the blood UREA and β2MG level of12months after treatment wasalso higher than before treatmen. But No statistical difference was found(p>0.05) inthese comparison.4.2In and Ⅱ-Ⅲ Cardiac functions patients of normal Renal function groupNo statistical difference was found in the blood Cr level between12months aftertreatment and before,6months after treatmen. In Cardiac functions patients ofimnormal Renal function group the blood Cr level of12months after treatment was alittle lower than of6months after treatment. But No statistical difference wasfound(p>0.05). In Ⅱ-ⅢCardiac functions patients the blood Cr level of6monthsafter treatment was a little lower than of before treatment. But No statistical differencewas found(p>0.05). And the blood Cr level of12months after treatment wasobviously lower than of before treatment(p<0.05).4.3In Cardiac functions patients of normal Renal function group No statisticaldifference was found in the blood Cystatin C level between12months and6monthsafter treatment(p>0.05). In Ⅱ-Ⅲ Cardiac functions patients the blood Cystatin Clevel of12months after treatment was lower than before,6months after treatmen,but No statistical difference was found(p>0.05). In Cardiac functions patients ofimnormal Renal function group the blood Cystatin C level of12months aftertreatment was obviously lower than of6months after treatment(p<0.05). And In Ⅱ-Ⅲ Cardiac functions patients the blood Cystatin C level of6months after treatmentwas also obviously lower than before treatment(p<0.05), the level of12months aftertreatment more low than before treatment(p<0.01).Statistical workAll the data were analysed statistically with SPSS13.0software ConclutionFor the cardiac insufficiency Patients with coronary heart disease, Statinsmedication based on the routine medication could protect the renal function., andserum cystatin C was the sense index.