目的 研究基因變異對(duì)服用瑞舒伐他汀的造影患者發(fā)生造影劑相關(guān)的急性腎損傷事件的影響。方法 考察貴州省人民醫(yī)院和廣東省人民醫(yī)院服用瑞舒伐他汀患者造影前后48 h的腎功能和造影劑相關(guān)的急性腎損傷事件，采用Sequenom Mass Array system對(duì)瑞舒伐他汀的藥動(dòng)學(xué)和藥效學(xué)相關(guān)基因進(jìn)行分型。結(jié)果 共635人納入了研究，其中30名患者發(fā)生造影劑相關(guān)的急性腎損傷。ABCG2 rs2231142（421C＞A）突變組的造影劑相關(guān)急性腎損傷風(fēng)險(xiǎn)顯著高于未突變組（OR：2.049；95% CI：1.185~3.542，P＝0.010）。經(jīng)基線校正后，差異仍具有顯著意義（OR：2.283；95% CI：1.247~4.182，P_adj＝0.008）。結(jié)論 ABCG2 421C＞A是服用瑞舒伐他汀患者發(fā)生造影劑相關(guān)的急性腎損傷事件獨(dú)立的危險(xiǎn)因素，服用瑞舒伐他汀且攜帶ABCG2 rs2231142 A等位基因的患者行造影時(shí)需警惕造影劑相關(guān)的急性腎損傷的發(fā)生。

Objective To study the effects of gene variations on the contrast-associated acute kidney injury event on patients with rosuvastatin and coronary angiography.Methods The renal function and contrast-associated acute kidney injury event of 48 h before and after angiography of patients with rosuvastatin were prospectively investigated. Pharmacokinetic and pharmacodynamic genotypes of rosuvastatin were detected by Sequenom Mass Array system, and the influences of these genes on contrast-associated acute kidney injury were analyzed.Results 635 Patients were included and 30 patients occurred contrast-associated acute kidney injury among them. The contrast-associated acute kidney injury risk in the ABCG2 rs2231142 (421C > A) mutation group was significantly higher than that in wild-type group (OR: 2.049; 95% CI: 1.185 — 3.542, P = 0.010). The difference was still significant after adjustment at baseline (OR: 2.283; 95% CI: 1.247 — 4.182, P_adj= 0.008).Conclusion ABCG2 421C > A is an independent risk factor of contrast-associated acute kidney injury events for patients with rosuvastatin. Patients taking rosuvastatin with ABCG2 rs2231142 A allele should be alert to the occurrence of contrast-associated acute kidney injury during angiography.

R969

國(guó)家自然科學(xué)基金資助項(xiàng)目（81960681）；貴州省科技支撐計(jì)劃項(xiàng)目（黔科合支撐[2018]2801）