| Objective: To investigate the preventive effect and safety of intensive-dose atorvastatin on contrast induced acute kidney injury(CIAKI) in patients of hypertension with chronic renal insufficiency undergoing percutaneous coronary intervention(PCI).Methods:Two hundreds and fifty patients of hypertension with chronic renal insufficiency undergoing PCI in Tianjin Chest Hospital were enrolled to the study. Patients were randomly divided to conventional treatment group(n=125)or intensive treatment group(n=125). The levels of blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance rate(Ccr), estimated glomerular filtration rate (eGFR), β2-microglobulin(β2-MG), urinary protein, C-reactive protein(CRP), tumor necrosis factor-a(TNF-a), interleukin-6(IL-6), alanine aminotransferase(ALT)were measured prospectively before the PCI and72h after the PCI. Observe the incidence of CIAKI after the PCI and the adverse reactions of atorvastatin in the two groups.Result:(1)The incidence of CIAKI in the intensive treatment group was lower than the conventional treatment group (1.6%vs9.6%, OR:0.135,95%CI:0.028-0.660, P=0.013).(2)There were no significant differences in the levels of BUN, Scr, urinary protein, Ccr, eGFR, β2-MG, CRP, IL-6,and TNF-a between the two groups before PCI;In the two groups, the levels of BUN, Scr, urinary protein, β2-MG, CRP, IL-6and TNF-α increased72h after PCI compared to before PCI, while the Ccr, eGFR decreased, the differences were statistically significant (P<0.01).(3)In the intensive treatment group72h after PCI, the levels of BUN, Scr, urinary protein, β2-MG, CRP, IL-6and TNF-a were lower than the conventional treatment group; while the Ccr, eGFR were higher, the differences were statistically significant (P＜0.05或P<0.01).(4)The levels of ALT after the procedure were similar (P>0.05), and no atorvastatin drug effects happened.Conclusion:(1)The administration of intensive-dose atorvastatin before PCI has protective effect on renal in patients of hypertension with chronic renal insufficiency.(2)The administration of intensive-dose atorvastatin before PCI has preventive effect on CIAKI in patients of hypertension with chronic renal insufficiency. The prevention mechanism may be due to the anti-inflammation effects of atorvastatin.(3)The effect of anti-inflammatory may be superior in the intensive treatment group to the conventional treatment group.(4)It is safe to use high dose of atorvastatin. |
