冠心病患者血清肌酐分布特征及其影响因素研究

目的探讨描述冠状动脉粥样硬化性心脏病（冠心病）患者血清肌酐水平与冠状动脉病变程度及影响因素的关系。方法搜集2007年8月至2008年8月间经冠状动脉造影检查确诊为冠心病的患者482例，分析患者血清肌酐水平与其临床特征及相关危险因素间的相关性，并探讨冠状动脉病变程度对肾功能影响。结果冠心病患者血清肌酐平均水平男性（96．36±10．28）μLmol／L，女性（83．98±11．36）μmol／L，男性高于女性（P〈0．01），其水平随着冠状动脉病变程度加重而升高，差异有统计学意义（P〈0．01），肾功能损害发生率为11．6％。血脂异常、超重、高血压、高尿酸、糖尿病患者和有吸烟史患者的血清肌酐水平高于正常范围（P〈0．05）；高尿酸、高血压和糖尿病患者肾功能损害的现患率高于正常组（P〈0．01）。多因素分析显示，高总胆固醇、高血压、高尿酸和高空腹血糖是肾功能损害的主要影响因素，其比数比值分别为1．36、1．98、3．58和1．46（P〈0．01）。随着冠状动脉病变程度的加重与危险因素的累加，血清肌酐水平明显上升。结论冠心病患者肾功能受损与各项危险因素水平及冠脉病变程度密切相关，在冠心病临床治疗中肾功能保护是一个不容忽视的方面。

Distribution of serum creatinine and influence factors analysis in CAD

Objective To observe the distribution of serum croatinine and analyze its associated influence factors in patients underwent coronary angiography. Methods Four hundred and eighty-two consecutive patients recieving coronary angiography from Aug, 2007 to Aug, 2008 at Beijing Anzhen hospital were enrolled. Results 1. The average level of serum creatinine of males (96. 36μmol/L) in male patients was significantly higher than females (83.98 μmol/L) (P < 0.01). The level of serum creatinine increased with severity of CAD (P < 0.01). The prevalence of renal dysfunction was 11.6% in this group. 2. Compared with normal people, the levels of serum creatinine were higher in groups of dyslipidemia, overweight, hypertension, hyperuricaemia, diabetes and smoking (P < 0. 05). The prevalence of renal dysfunction was higher in groups of hypercholesterolaemia, hypertension, diabetes and hyperuricaemia. 3. Hypercholesterolaemia, hypertension, diabetes and hyperuricaemia were main influencing factors of renal dysfunction, with OR 1.36, 1.98, 3.58 and 1.46 (P<0.01). 4. Level of serum creatinine increased significantly with the severity of CAD. Conclusion Gender, lipids, blood pressure, uric acid, body mess index, smoking and diabetes show influence on serum creatinine level. Hyperoholesterolaemia, hyperten-sion and hyperuricaemia are main influencing factors of renal dysfunction.