CLINICAL STUDY OF PITAVASTATIN COMBINED WITH ACETYLCYSTEINE IN THE PREVENTION OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS

Objective: To analyze the clinical efficacy of pitavastatin combined with acetylcysteine in the prevention of contrast-induced nephropathy (CIN). Methods: Patients with diabetic nephropathy who received coronary intervention with Ultravist 370 contrast agent in the Department of Cardiology from May 2018 to May 2019 were selected for a study involving 80 patients. The patients were divided into statin treatment groups according to a random number table: one group received pitavastatin, the acetylcysteine group was administered with acetylcysteine, the control group received no further treatment, and the combination group received pitavastatin combined with acetylcysteine. There were 20 cases in each group. Changes in serum creatinine (Scr), beta 2-microglohulin (beta 2-MG), urea nitrogen (BUN), 24 h total urinary microprotein (24hUpro), and urinary albumin excretion rate (UARE) levels were observed in all patients 2 d before and 3 d, and 7 d after PCI to calculate the random urinary albumin/creatinine ratio (ACR). The occurrence of GIN after percutaneous coronary intervention (PCI) was recorded. Results: After surgery, the levels of 3 d Scr, beta 2-MG, BUN, 24hUpro, UARE, and ACR in the four groups were higher than those before surgery. The levels of Scr, beta 2-MG, BUN, 24hUpro, UARE and ACR in the control group were significantly higher than those in the statin group, acetylcysteine group and combination group (P<0.05). Scr, beta 2-MG, BUN, 24hUpro, UARE, and ACR levels in the combination group were significantly lower than the statin group and acetylcysteine group (P<0.05); The levels of Scr, beta 2-MG, BUN, 24hUpro, UARE and ACR in the combination group were significantly lower than those in the other three groups (P<0.05). The incidence of CIN in the combination group was 5%, which was significantly lower than the other three groups, and the difference was statistically significant (P<0.05). Conclusion: Pitavastatin combined with acetylcysteine can significantly reduce renal function damage caused by PCI, improve oxidative stress and reduce the incidence of CIN.