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目的探究标准剂量阿托伐他汀在急性冠脉综合征(ACS)合并慢性肾功能不全患者治疗中对肾功能的影响。方法本院就诊的ACS合并肾功能不全(CKDⅡ~Ⅳ期)的患者共200例,按单双号随机入组法分为阿托伐他汀组100例(观察组)与其他他汀组100例(对照组)。观察组给予阿托伐他汀20mg/晚,对照组给予标准剂量他汀(辛伐他汀40mg或瑞舒伐他汀10mg)。于入院及出院后1个月检测两组患者相关生化指标并进行比较。结果观察组与对照组在治疗1个月后,其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)等均较前显著下降(P<0.01或P<0.05),但两组间差异无统计学意义(P>0.05),而观察组患者肾小球滤过率有所上升(P<0.05),对照组患者肾小球滤过率变化不明显(P>0.05)。结论针对ACS合并慢性肾功能不全的患者,短期标准剂量阿托伐他汀对比标准剂量其他他汀类药物,对肾脏保护功能更大。
Objective To investigate the effects of standard-dose atorvastatin on renal function in patients with acute coronary syndrome (ACS) complicated with chronic renal failure. Methods A total of 200 patients with ACS with renal insufficiency (CKDⅡ-Ⅳ) were enrolled in this study. One hundred patients in the atorvastatin group (observation group) and 100 in the other statin group Control group). The observation group was given atorvastatin 20 mg / night and the control group was given the standard dose of statin (simvastatin 40 mg or rosuvastatin 10 mg). One month after admission and discharge, the biochemical indexes of two groups were tested and compared. Results The levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in observation group and control group were significantly lower than those in the control group (P <0.01 or P < 0.05). However, there was no significant difference between the two groups (P> 0.05), while the glomerular filtration rate of the observation group increased (P <0.05), while the glomerular filtration rate of the control group did not change significantly P> 0.05). Conclusions A short-term standard dose of atorvastatin compared to standard doses of other statins for patients with ACS complicated with chronic renal failure has greater protective effects on the kidneys.