120例老年冠心病患者合并肾功能不全的临床分析

目的探讨老年冠心病患者合并肾功能不全的临床特点。方法回顾分析我院收治的120例老年冠心病患者的临床资料，根据入院时测定的血清肌酐值和MDRD公式估测肾小球滤过率（eGFR）。将120例患者分为肾功能不全组eGFR〈60ml·min^-1·（1．73m^2）^1]和对照组，对比观察两组住院期间不良心血管事件的发生率。结果120例患者肾功能不全发生率为44％。肾功能不全组与对照组相比，急性心肌梗死发生率明显升高（66．04％比32．84％，P〈0．01）；心衰发生率显著增多（52．83％比25．37％，P〈0．01）；住院期间死亡率显著增高（28．3％比7．46％，P〈0．01）；糖尿病发生率高（58．49％比31．34％，P〈0．05）。结论合并肾功能不全的老年冠心病患者急性心肌梗死、心衰发生率高，多合并糖尿病，住院期间死亡率高。

Clinical analysis for 120 elderly patients with coronary heart disease and renal dysfunction

Objective To explore the clinical aspects of elderly with combined coronary heart disease （CHD） and renal dysfunction. Methods 120 elderly with coronary heart disease were divided into 2 groups based on their value of blood serum creatinine and estimated glomerular filtration rate （eGFR） which determined by the MDRD equation. Patients with eGFR〈60 ml·min^-11 （1.73m^2）^-1 were defined as renal dysfunctional group where the rest were considered as normal renal functional group. The incidences of adverse cardiovascular events were then analyzed and evaluated. Results Fifty-three patients out of 120 were considered as renal dysfunctional group （44%）. Compared to the normal renal functional group, the incidence of acute myocardial infarction （66.04% vs 32.84%,P〈0.01 ）, heart failure （52.83% vs 25.37%,P〈0.01） and rate of mortality （28.3% vs 7.46%,P〈0.01） was significantly higher in patients with renal dysfunction, furthermore, patients in renal dysfunctional group revealed a higher incidence of type 2 diabetes occurrence compared to normal renal functional group as shown with a significant difference （58.49% vs 31.34%,P〈0.05）. Conclusion A greater incidence of acute myocardial infarction and heart failure was associated with elderly with CHD combined with renal dysfunction, as well as an increased the rate of type 2 diabetes occurrence and mortality in hospital.