血清肌酐和估算的肾小球滤过率对评价冠状动脉介入治疗术患者的比较研究

目的比较血清肌酐（SCr）和估算的肾小球滤过率（eGFR）在评价冠状动脉介入治疗（PCI）患者预后的价值。方法应用酶法测定1 005例接受PCI患者的SCr和eGFR,采用简化的肾病膳食改良实验（MDRD）方程进行计算。分别用SCr和eGFR作为评价患者肾功能的指标,将患者分为肾功能正常组（SCr-A、eGFR-A）和肾功能损伤组（SCr-B、eGFR-B）。比较SCr-A组和SCr-B组、eGFR-A组和eGFR-B组患者年龄、吸烟、高血压、糖尿病、左室射血分数（LVEF）和术后住院天数的差异,同时评价SCr和eGFR与PCI患者术后3年内发生心脏事件的相关性。结果 SCr-A和SCr-B组患者除年龄、高血压、LVEF差异有统计学意义外（P〈0.05）,其余指标差异均无统计学意义（P〉0.05）。而eGFR-A和eGFR-B组患者在年龄、吸烟、高血压、糖尿病、LVEF和术后住院天数差异均有统计学意义（P〈0.05）。术前SCr与术后3年内发生的心脏事件（MACE）的比值比（OR）为1.006[95%可信区间（CI）：0.998～1.014,P=0.146];术前eGFR与术后3年内的心脏事件的OR为0.994（95%CI：0.984～1.003,P=0.178）;单纯的SCr和eGFR在评价PCI患者预后作用相似,与术后3年内发生MACE无相关性（P〉0.05）。结论单纯的eGFR和SCr在评估PCI患者的危险分层和预后效果相似。

Comparison study of serum creatinine and estimated glomerular filtration rate in the evaluation of the percutaneous coronary intervention in patients

Objective To compare the prognostic value between serum creatinine（SCr） and estimated glomerular filtration rate（eGFR） in the evaluation of percutaneous coronary intervention（PCI） in patients.Methods The SCr was determined in 1 005 patients receiving PCI treatment by enzymatic method,and the SCr and eGFR were calculated with improved simplified experimental kidney diet（MDRD） equation.The SCr and eGFR were used as indicators of renal function evaluation,while these patients were classified into 2 groups,group A with normal renal function（SCr-A,eGFR-A） and group B with renal function damage（SCr-B,eGFR-B）.The differences of age,smoking,hypertension,diabetes mellitus,left ventricular ejection fraction（LVEF） and the postoperative hospital stay days were analyzed.The correlation of SCr and eGFR with cardiac events for 3 follow-up years was evaluated. Results SCr-A and SCr-B group was significantly different in age,hypertension and LVEF（P〈0.05）,while the eGFR-A and eGFR-B group were statistically different in age,smoking,hypertension,diabetes mellitus,LVEF and postoperative hospital stay days（P〈0.05）.The odds ratio（OR） in preoperative SCr and postoperative major adverse cardiac events（MACE） occurred within 3 years was 1.006[95% confidence interval（CI）：0.998-1.014,P=0.146].The OR in preoperative eGFR and postoperative cardiac events after 3 years was 0.994（95% CI：0.984-1.003,P=0.178）. Conclusions The eGFR and SCr have the similar value as effective indicators in patients scheduled for PCI risk stratification and assessment of of prognosis.