Different Doses Of Atorvastatin The Prevention Of Contrast Induced Nephropathy

Background: With the social and economic development, people's living standardshave markedly improved, life expectancy has been significantly longer than before.Hard for patients with coronary artery showed an explosive increase in the deathof contemporary society has become the first killer .angioplasty has become thetreatment of vascular disease, the main technology. Contrast agent (formerly knownas contrast agent) has been widely used in clinical. Contrast induced nephropathy(contrast induced nephrpathy, CIN), a contrast agent-related iatrogenic diseasecaused by the increasing attention of clinicians. Research shows that in thegeneral coronary angiography and stent implantation in patients, CIN incidenceof 1.5-13% [1,2], in diabetes, chronic renal insufficiency, heart failure population,contrast agent nephropathy incidence rate as high as 40-50% [3]. Nash et al [4]reported that CIN is a hospital-acquired renal failure in the first three reasons.Unfortunately, there is no ideal for the prevention of CIN. Hydration therapy iswidely recognized to reduce the incidence of CIN and effective method. Itsmechanism is not entirely clear and may dilute the concentration of contrast mediumwithin the renal tubules, and less renin - angiotensin - aldosterone generationand so on. In recent years, the role of statins to prevent CIN growing concernMethods: 143 cases of coronary angiography and stent implantation patients werechose at the First Hospital, Shanxi Medical University from June 2009 to December2010 as research subjects, which is randomly divided into, group A, group B andgroup C. group A = 40mg 52 cases; group B = 20mg 51 cases, group C = 10mg 40 cases.Enrolled patients were given atorvastatin calcium tablets orally at bedtime beforeand after surgery. monitoring serum creatinine (Scr), blood urea nitrogen (BUN),serum cystatin C (Cys-c), bloodβ2-microglobulin (β2-MG), high sensitivityC-reactive protein ( hs-CRP) and urinaryα1-microglobulin (α1-MG)'s changesBefore and after operation, 24h, 72h. Then Calculated (Ccr) clearance by theCockcroft-Gault creatinine. Scr increased 25% compared with the preoperativewithin 72h after operation or the absolute increase in 44.2μmmol / L (0.5mg/dl)is regard as contrast induced nephropathy (contrast induced nephropathy, CIN),and its mechanism.Result: The three groups have different biochemical targets, but no statistical significance (P> 0.05). Group A Ccr was higher than group C and group B afteroperation 24h, but no statistically significant (P> 0.05), group A Ccr weresignificantly higher than group C after operation 72h (P <0.05); higher than thegroup B, but no significant significance (P> 0.05); Group B were notsignificantly different Ccr with the C group after operation 24h, higher than groupC after 72 h (P <0.05); Group A after operation 24h, 72h serumβ2-MG, Cys-c,urinaryα1-MG, urinary mALB significantly different than group C, wasstatistically significant (P <0.05);Group A after operation 24h, 72hβ2-MGcompared with group B has difference and was statistically significant. B groupafter 24h, 72hCys-c, urinaryα1-MG, urinary mALB than C group was significantly(P <0.05), but the increase was higher than A group (P> 0.05)Conclusion: Coronary angiography and stent implantation in patients before taking40mg compared with 10mg and 20mg atorvastatin can reduce the contrast medium onrenal function damage.