老年急性冠脉综合征患者肾小球滤过率与冠脉病变程度、高敏C-反应蛋白的相关性研究

目的 评价老年急性冠脉综合征（ACS）患者入院时估算的肾小球滤过率（eGFR）与冠脉病变程度和血浆高敏C-反应蛋白（hs-CRP）的相关性.方法 选择284例老年ACS患者,在入院后12 h内行血肌酐等常规检查,同时检测血浆hs-CRP.结果 肾功能不全的比率为55.30%,肾功能不全总组及肾功能不全轻、中、重组Gensini评分均较正常肾功能组显著增高（P〈0.01,P=0.01,P〈0.01,P〈0.001）.肾功能不全总组及重度肾功能不全组血浆hs-CRP显著增高（P=0.02,P〈0.01）.与Gensini评分〈30组相比较,高hs-CRP和肾功能不全比率Gensini评分30～90组和Gensini评分〉90组均显著增高（P〈0.01,P〈0.01）.偏相关分析表明,eGFR及血浆hs-CRP分别与Gensini评分相关（r=-0.110,P=0.005;r=0.045,P=0.01）.多元回归分析表明,eGFR及血浆hs-CRP分别与Gensini评分独立相关（β=-0.113,P〈0.01;β=0.035,P〈0.01）.血浆hs-CRP与eGFR无相关性.结论 老年ACS患者eGFR水平与冠脉病变程度独立相关,与血浆hs-CRP结合可能更有利于老年ACS患者的临床评价.

Association of the severity of coronary artery stenosis, hs-C reactive protein and glomerular filtration rate in elderly patients with acute coronary syndromes

Objective To explore the correlation of the estimated glomerular filtration rate （eGFR）, the severity of coronary artery stenosis and plasma Hs-C reactive protein（hs-CRP） in elderly patients with acute coronary syndromes（ACS）. Methods Serum creatinine and hs-CRP within 12 hours were analyzed in 284 elderly patients with acute coronary syndromes. Results Incidence of renal disfunction was 55.30%, Gensini score in these patients were higher than those with normal renal function （P〈0.01）. The percentages of high hs-CRP and renal disfunction were significantly higher in patients with Gensini score 30-90 and patients with Gensini score〉90 compared patients with Gensini score 〈30 （P〈0.01 ,P〈0.01 ）. Partial correlation analysis showed Gensini score correlated with eGFR and plasma hs-CRP （r=-0.110,P=0.005,r=0.045,P=0.01）. Mutiple linear regression analysis showed both eGFR and plasma hs-CRP correlated independently with Gensini score（fl=-0.113,P〈0.01 ,fl=0.035, P〈0.01 ） while plasma hs-CRP was not correlated with eGFR. Conclusion eGFR independently correlated with Gensini score in elderly patients with acute coronary syndromes and the conrbined measurement of plasma hs-CRP are helpful in evaluating the prognosis of elderly patients with acute coronary syndromes.