慢性肾功能不全与冠状动脉病变程度的关系

目的:了解慢性肾功能不全对冠状动脉病变的影响。方法:连续入选2005年3月至2011年3月,于我院接受冠状动脉造影(coronary angiography,CAG)检查的患者共1 394例,根据患者入院肾小球滤过率(estimated glomerular filtration rate,eGFR)检查结果分为肾功能正常(n=671)、轻度肾功能减退(n=253)和中重度肾功能减退(n=62)三组。比较各组患者的临床特点以及冠状动脉病变严重程度。结果:各组患者在性别比例、年龄、体质量指数(BMI)、急性冠状动脉综合征(acute coronary syndrome,ACS)患病比例、高血压病史、糖尿病史、心力衰竭病史、脑血管病史、SBP、HbA1c、TG、TC和LDL-C等方面,均差异有统计学意义(P0.05)。中重度肾功能减退的患者冠状动脉病变程度严重的比例,显著高于其余两组高,2支病变(P=0.001)、3支病变(P=0.001)、左主干病变(P=0.001)、LAD近端病变(P=0.027)以及开口病变(P=0.005)所占比例显著升高。多因素分析,校正其他因素后,慢性肾功能不全是冠状动脉病变严重程度的独立预测因素(RR=2.33,95%CI:1.74~5.10)。结论:慢性肾功能不全与冠状动脉病变严重程度有密切相关性。

Relations with chronic renal dysfunction and the extent of coronary artery disease

Objective：To assess whether renal insufficiency is significant independent predictors of coronary artery disease.Methods：We enrolled 1 394 coronary artery disease patients undergoing coronary angiography procedures continuously from March,2005 to March,2011.Patients were classified as the level of glomerular filtration rate （eGFR）.eGFR was calculated Estimated glomerular filtration rate （mL· min-1 · 1.73 m-2） =186 × （Cr）-1.154 × （age）-0.203 × （0.742 if female） × （1.233 if Chinese）.Depending on their baseline eGFR patients were classified into three groups：normal renal function; mild renal impairment and severe renal insufficiency.We compared the clinical features and coronary artery lesions of patients.Results：Significant differences were found among the groups regarding female gender,age,body mass index,prior history of hypertension,diabetes mellitus,prior stroke,heart failure,acute coronary syndrome,SBP,HbA1c,TG,TC,LDL-C （P＜0.05） and risk of multivessel severe stenosis （P ＜ 0.001）.When evaluated as continuous variables,eGFR was independent predictors of coronary artery lesions （RR =2.33,95％ CI：1.74 ～ 5.10）.Conclusion：Renal insufficiency and coronary artery lesion severity has close correlation.