冠心病患者动脉粥样硬化性肾动脉狭窄的临床筛选方法研究

目的建立从临床上筛选出动脉粥样硬化性肾动脉狭窄（ARAS）的简单易行的预测公式。方法分析892例冠状动脉造影并行非选择性肾动脉造影患者的临床资料，采用单因素相关分析得出与ARAS相关的风险因素，再通过多因素Logisitc回归分析得出各风险因素之间的比例关系，根据这种比例关系建立简单的评分系统，再将评分代人患者中，分析其敏感性及特异性。结果在冠状动脉粥样硬化人群中ARAS的患病率为12．7％，风险因素为年龄、体质量指数、血肌酐、高血压病史、糖尿病病史、缺血性脑血管病病史与顽固性高血压。根据以上风险因素建立相应的评分系统，患者的评分分值由5．5分至20．5分不等。随着分值的增加，ARAS的发病率明显升高。结论本研究所建立的简单临床预测公式可以有效的对冠状动脉粥样硬化患者进行初步的筛选，为是否采取敏感度高但较为昂贵的检查进行确诊提供参考。

Study on clinical screening method of atherosclerotic renal artery stenosis in patients with coronary artery disease

【Abstract】 Objective To establish a prediction formula for screening atherosclerotic renal artery stenosis (ARAS). Methods Clinical data of 892 patients who suffered from coronary artery disease (CAD) with renal artery angiography were reviewed. The clinical characters related to ARAS were analyzed and Logisitc regression was used to reveal the ratio of every clinical character. Based on the ratio, a prediction formula was established. Then sensitivity and specificity of this prediction formula was examined back to the patients. Results The patients who suffered from ARAS in CAD population accounted for 12.7%. The risk factors included age, BMI, Scr, hypertension history, diabetes mellitus (DM)，stroke and refractory hypertension. Age, BMI and Scr were used as continuous variables and other four as dichotomized variables. According to the prediction formula, the score was from 5.5 to 20.5. With the score increasing, the probability of ARAS increased as well. Conclusion This prediction formula is helpful to select the ARAS patients from CAD population, in order to provide them the evidence for further examination.