论文部分内容阅读
目的:探讨老年冠心病患者肾功能减低与冠状动脉病变严重程度的关系。方法:219例经冠状动脉造影确诊且未合并原发肾脏疾病的老年冠心病患者,以简化MDRD公式计算肾小球滤过率,依据冠状动脉造影结果判断冠状动脉病变严重程度。结果:104例(47.5%)患者肾功能减低,其中慢性肾脏疾病患者37例(16.9%);严重冠状动脉病变患者117例(53.4%)。严重冠状动脉病变患者肾小球滤过率明显减低(P<0.05)。肾小球滤过率<70mL/(min.1.73m2)为严重冠状动脉病变的最强预测因子(P<0.05)。既往高血压病史、合并糖尿病、低密度脂蛋白胆固醇>2.6mmol/L及低高密度脂蛋白胆固醇也是严重冠状动脉病变的独立预测因素。结论:合并肾功能下降是老年冠心病患者发生严重冠状动脉病变的独立危险因素,其预测价值超过传统冠心病危险因素。
Objective: To investigate the relationship between the severity of coronary artery lesion and the renal function decline in elderly patients with coronary heart disease. Methods: 219 elderly coronary heart disease patients confirmed by coronary angiography without primary renal disease were treated with simplified MDRD formula to calculate glomerular filtration rate. The severity of coronary artery disease was determined by coronary angiography. Results: The renal function of 104 patients (47.5%) was decreased, including 37 patients (16.9%) with chronic kidney disease and 117 patients (53.4%) with severe coronary artery disease. Glomerular filtration rate was significantly lower in patients with severe coronary artery disease (P <0.05). Glomerular filtration rate <70 mL / (min.1.73 m2) was the strongest predictor of severe coronary artery disease (P <0.05). Previous history of hypertension, with diabetes, low density lipoprotein cholesterol> 2.6 mmol / L, and low-density lipoprotein cholesterol were also independent predictors of severe coronary artery disease. Conclusion: The decline of combined renal function is an independent risk factor for severe coronary artery disease in elderly patients with coronary artery disease, and its predictive value exceeds the risk factors of traditional coronary heart disease.