Study On Prevalence And Influencing Factors Of Contrast Induced Nephropathy Among Patients With PCI Surgery And Treating With Different Doses Of Atorvastatin In The Preoperative

ObjectiveThe aim of this study was to understand the status and distribution of the contrast induced nephropathy(CIN)among patients with PCI surgery.And explore the associations between the demographic characteristics,clinical indicators and CIN,for the purpose of providing relevant theoretical basis of CIN.MethodsClinically,CIN usually refers to the presence of acute renal impairment in patients within 3 days of the use of contrast agents after exclusion of causes such as ischemia,atherosclerosis,thrombosis,and other nephrotoxicities.A sample with 128patients were selected in this study on March 2016 to March 2015 from department of cardiology of the first Affiliated Hospital of Anhui Medical.and they were randomly divided into strengthening group(n=64,with 80mg of atorvastatin)and regular group(n=64,with 20 mg of atorvastatin)according to the dosage of atorvastatin given before PCI.The postoperative glomerular filtration rate(eGFR),serum creatinine(Scr),Urine beta 2 globulin,Cystatin C(Cys C),creatine kinase(CK),AST and ALT of different groups were tested in all patients.The rates of CIN after PCI were also compared between the 2 groups.And the multivariate logistic regression was used to study the influencing factors of CIN.ResultsThere were higher level of CK of PCI postoperative 3 days and lower level of CysC of PCI postoperative 3 days、Scr of PCI postoperative2 and 3 days in strengthening group than in the regular dose group(P<0.05).The rates of CIN was lower in the strengthening group than in the regular dose group(6.3%VS 18.8%,?~2=4.57,P=0.03).The level of eGFR、SCr、Urine beta 2 globulin and CK in two groups had statistically significant difference between different time(F value was15.46,16.07,12.27 and 6.19,respectively.P<0.001).The result of multiple Logistic regression showed that age,hypertension,heart failure,and dose of atorvastatin were independent risk factors for CIN of patients treated by PCI.And there was lower probability of CIN patients after PCI with 32%lower in strengthening group than in the regular dose group(OR:0.68,95%CI:0.56~0.83,P<0.05).ConclusionsThe hypertension was still an important public health problem among the rural adult residents in areas along the Yangtze river in Anhui province.It’s important to improve the rates of awareness,treatment and control among the participants of hypertension.The CIN was strongly associated with the age,hypertension,heart failure and the dose of atorvastatin.Administration of high dose atorvastatin before PCI may decrease the occurrence of CIN after PCI for AMI patients and protect the patient’s kidney function.It was worth clinical popularization and application.