慢性肾脏病对冠心病预后的影响

目的:探讨包括轻度肾损害在内的慢性肾脏病(CKD)对冠心病(CAD)预后的影响.方法:收集我院2000年1月至2004年12月心血管内科和胸外科符合入选标准的疑似冠心病患者,以冠脉造影为冠心病的诊断依据,对确诊为冠心病的579例患者,结合其再住院情况及随访情况,了解冠心病患者目前有无主要临床事件如心绞痛、心肌梗死、再梗死、心力衰竭、晕厥、脑卒中、死亡等情况.将患者按肾功能损害程度(正常、轻度、中度、重度)分为4组,比较不同程度的慢性肾脏损害对冠心病预后的影响.结果:不同肾功能水平相比,冠心病的各种临床事件如:心绞痛、心肌梗死、再梗死、心力衰竭、脑卒中的发生率存在显著差别;肾功能越差,心绞痛、心肌梗死、再梗死、心力衰竭、脑卒中等发生率越高.结论:肾功能损害程度与冠心病患者危险呈正相关,随着肾功能损害程度加重,冠心病的各种临床事件发生率越高,其预后也越差.

Influence of chronic kidney disease on prognosis of coronary artery disease

Objective:To investigate the influence of chronic kidney disease(CKD),including slight renal damages,on prognosis of coronary artery disease(CAD).Methods: A retrospective study was performed in 732 patients who visited our Cardiology Department and Cardiothoracic Surgery Department in 2000-2004.All patients suspected of CAD underwent a selective coronary angiography.Five hundred and seventy-nine patients with established diagnosis of CAD were followed up and their cardiovascular events(angina pectoris,myocardial infarction,recurrent myocardial infarction,heart failure,stroke,death,etc.) were recorded.Patients with CAD were divided into normal,slight,moderate,and severe groups according to the degree of renal function damages.The influences of different degrees of renal damages on the prognosis of CAD were compared.Results: There were obvious differences in the morbidities of angina pectoris,myocardial infarction,recurrent myocardial infarction,heart failure,stroke,etc.in CAD patients with different degrees of renal function damages.The worse the renal function,the higher the incidences of angina pectoris,myocardial infarction,recurrent myocardial infarction,heart failure and stroke,etc((P<0.05).) Conclusion: The severity of chronic renal insufficiency is positively correlated to the risks of CAD.The worse the renal function,the higher the incidence of cardiovascular events and the worse of CAD prognosis.