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目的研究高龄急性冠状动脉综合征(ACS)患者的冠状动脉狭窄程度与肾功能指标的相关性。方法连续入选536例年龄≥80岁的ACS患者,根据Gensini评分将患者分为对照组66例,轻度狭窄组141例,中度狭窄组167例,重度狭窄组162例。比较各组肾功能指标与Gensini评分的相关性。结果与对照组比较,轻度狭窄组、中度狭窄组和重度狭窄组患者随着冠状动脉狭窄程度的加重,血清肌酐、尿素和胱抑素C水平明显升高(P<0.01),估算肾小球滤过率(eGFR)明显降低(P<0.05)。血清肌酐(r=0.1 93,P=0.000)、尿素(r=0.194,P=0.000)、胱抑素C(r=0.295,P=0.000)与Gensini评分呈正相关,eGFR(r=-0.160,P=0.001)与Gensini评分呈负相关。结论年龄≥80岁ACS患者冠状动脉狭窄程度与肾功能指标密切相关。血清胱抑素C水平最敏感。
Objective To investigate the correlation between coronary stenosis and renal function in elderly patients with acute coronary syndrome (ACS). Methods A total of 536 patients with ACS ≥80 years old were enrolled and divided into control group (66 cases), mild stenosis group (141 cases), moderate stenosis group (167 cases) and severe stenosis group (162 cases) according to Gensini score. The correlation between renal function indexes and Gensini scores was compared between the groups. Results Compared with the control group, the levels of serum creatinine, urea and cystatin C were significantly increased in patients with mild stenosis, moderate stenosis and severe stenosis as the degree of coronary artery stenosis increased (P <0.01) The glomerular filtration rate (eGFR) was significantly reduced (P <0.05). Serum creatinine (r = 0.193, P = 0.000), urea (r = 0.194, P = 0.000) and cystatin C (r = 0.295, P = 0.000) were positively correlated with Gensini score, while eGFR P = 0.001) was negatively correlated with Gensini score. Conclusion The degree of coronary artery stenosis in patients with ACS ≥ 80 years old is closely related to renal function. Serum cystatin C is the most sensitive.