目的 研究基因变异对服用瑞舒伐他汀的造影患者发生造影剂相关的急性肾损伤事件的影响。方法 考察贵州省人民医院和广东省人民医院服用瑞舒伐他汀患者造影前后48 h的肾功能和造影剂相关的急性肾损伤事件，采用Sequenom Mass Array system对瑞舒伐他汀的药动学和药效学相关基因进行分型。结果 共635人纳入了研究，其中30名患者发生造影剂相关的急性肾损伤。ABCG2 rs2231142（421C＞A）突变组的造影剂相关急性肾损伤风险显著高于未突变组（OR：2.049；95% CI：1.185~3.542，P＝0.010）。经基线校正后，差异仍具有显著意义（OR：2.283；95% CI：1.247~4.182，P_adj＝0.008）。结论 ABCG2 421C＞A是服用瑞舒伐他汀患者发生造影剂相关的急性肾损伤事件独立的危险因素，服用瑞舒伐他汀且携带ABCG2 rs2231142 A等位基因的患者行造影时需警惕造影剂相关的急性肾损伤的发生。

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

国家自然科学基金资助项目（81960681）；贵州省科技支撑计划项目（黔科合支撑[2018]2801）