目的提高对急性冠脉综合征、肾动脉狭窄、急性左心衰三联征的诊治率。方法回顾性分析25例急性冠脉综合征、肾动脉狭窄、急性左心衰三联征患者的临床资料,分析基线资料与预后的关系。结果高血压、陈旧性心梗、陈旧性脑梗、高脂血症、糖尿病、吸烟、周围血管病等危险因素的发生率分别为100%、54.0%、60.0%、40.0%、48.0%、36%;出现典型心绞痛症状至冠心病确诊(发生心梗/冠脉造影/冠脉CT确诊)平均为5.3年,冠心病确诊-肾动脉狭窄确诊约6.2年,心绞痛症状至肾动脉狭窄确诊约11.5年。造影结果13例为双侧肾动脉狭窄,平均冠脉病变为2.6支,确诊后所有患者进行了冠脉和(或)肾动脉介入或冠脉搭桥术。2例治疗无效死亡,其余23例好转出院,其中3例肾功能较入院时恶化。2年随访期内12例病情好转或稳定,4例死亡,7例发生次级终点事件;因小样本及选择偏倚,无基线资料与预后相关。结论三联征术后及两年预后较差,早期诊断、治疗才能减少发病率及改善预后。 Objective To improve the diagnosis and treatment of acute coronary syndrome, renal artery stenosis and acute left heart failure triad. Methods The clinical data of 25 patients with acute coronary syndrome, renal artery stenosis, acute left heart failure triad were retrospectively analyzed. The relationship between baseline data and prognosis was analyzed. Results The incidence of hypertension, old myocardial infarction, old cerebral infarction, hyperlipidemia, diabetes, smoking, peripheral vascular disease and other risk factors were 100%, 54.0%, 60.0%, 40.0%, 48.0%, 36 %; Typical angina symptoms to diagnosis of coronary heart disease (diagnosis of myocardial infarction / coronary angiography / coronary CT) was 5.3 years, diagnosis of coronary heart disease - diagnosis of renal artery stenosis of about 6.2 years, angina pectoris to renal artery stenosis diagnosed about 11.5 year. 13 cases of bilateral renal artery stenosis results, the average coronary artery disease was 2.6, all patients diagnosed after coronary artery and / or renal artery bypass or coronary artery bypass surgery. Two cases died of treatment ineffectiveness, and the remaining 23 cases were discharged. Among them, 3 cases had worse renal function than hospitalized. Twelve patients were either better or stable during the 2-year follow-up period, 4 died, and 7 had secondary endpoints. There were no baseline data associated with outcome because of small sample size and bias in selection. Conclusions The triad is worse than the two-year prognosis. Early diagnosis and treatment can reduce the incidence and improve the prognosis.