摘要
目的探讨慢性肾功能不全对冠心病临床表现及预后的影响。方法收集2006年6月至2007年12月明确诊断冠心病的老年患者142例,根据是否合并慢性肾功能不全分组,对比临床特点和冠状动脉病变情况,随访心血管事件发生情况。结果 (1)慢性肾功能不全的冠心病患者与对照组比较,高血压发病率高(79.6%vs59.1%,P<0.05)、左室射血分数低〔(50.6%±9.5%)vs(54.8%±6.2%),P<0.01〕、室间隔厚度增加〔(12.2±0.9)mmvs(11.5±0.6)mm,P<0.001〕。(2)慢性肾功能不全组与对照组比较,三支病变多(69.4%vs31.8%,P<0.001),多处钙化病变多(57.1%vs29.5%,P<0.01),接受介入治疗比例低(24.5%vs52.3%,P<0.001),药物治疗多(70.4%vs34.1%,P<0.001)。(3)肾功能不全组发生急性冠脉综合征(53.1%vs27.3%,P<0.05)、急性左心衰竭(27.6%vs11.4%,P<0.05)的比例明显高于对照组。(4)Logistic分析显示,收缩压水平(β=0.65,P<0.001)和肾小球滤过率(β=-0.49,P<0.001)是随访期内冠心病患者发生不良心血管事件重要的独立危险因素。结论肾功能不全的冠心病患者冠脉病变广泛,钙化明显,接受再血管化治疗的比例低;随访期心血管事件的发生率高但症状不典型。慢性肾功能不全是冠心病病情发生发展的重要预测指标。
Objective To investigate the clinical features and prognosis of coronary artery disease in patients with chronic renal failure.Methods A retrospective study was performed on 142 elderly patients with coronary artery disease diagnosed between June 2006 and December 2007.According to the complication of renal failure or not,the subjects were divided into chronic renal failure group （n=98） and non-chronic renal failure （control） group （n=44）.The clinical characteristics,coronary artery lesions and main cardiac adverse events （MCAE） were compared between the two groups.Results （1） Compared with control group,the hypertension incidence was higher （79.6% vs 59.1%,P0.05）,and left ventricular ejection fraction was lower 〔（50.6±9.5）% vs （54.8±6.2）%,P0.01〕in renal failure group.（2） There were more cases with triple vessel lesions,more cases with calcification,more cases receiving medication,and less cases receiving percutaneous coronary intervention in chronic renal failure group than in control group （69.4% vs 31.8%,P0.001;57.1% vs 29.5%,P0.01;70.4% vs 34.1%,P0.001;24.5% vs 52.3%,P0.001 respectively）.（3）The incidence of acute coronary syndrome and incidence of acute heart failure were higher in renal failure group than in control group（53.1 % vs 27.3%,27.6% vs 11.4% respectively,P0.05）.（4）Logistic analysis showed that bedside systolic blood pressure （β=0.65,P0.001） and glomerular filtration rate （β=-0.49,P0.001） were independent risk factors for MCAE in patients with coronary heart disease.Conclusion There are more extensive coronary lesions,more obvious calcification,and lower percentage of revascularization in coronary artery disease patients with renal failure.They also have higher incidence of,but asymptomatic MCAE.Chronic renal failure is an important predictor for the development and prognosis of coronary artery disease.
出处
《中华老年多器官疾病杂志》
2010年第2期127-130,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
冠状动脉疾病
肾功能衰竭
慢性
coronary artery disease
chronic renal failure
作者简介
Tel：13269869981
