健康人群心血管危险因素与肾小球滤过率的相关性  

Correlation of cardiovascular risk factors versus glomerular filtration rate in healthy population

作　　者：刘静[1] 白小涓[1] 韩璐璐[1] 张伟光[1] 周红瑜[1] 董绍臣[1] 孙颖[1] 陈香美[2] 

机构地区：[1]中国医科大学附属第一临床学院老年干诊科,沈阳110001 [2]解放军总医院肾内科

出　　处：《中华医学杂志》2009年第24期1676-1680,共5页National Medical Journal of China

基　　金：国家重点基础研究发展计划基金（G2007CB507405）;辽宁省科学技术厅课题基金（2007225004）

摘　　要：目的评价健康人群心血管危险因素及其严重程度与肾小球滤过率（GFR）的相关性。方法以沈阳社区为基础的横断面研究，利用Framingham危险评分方程评价501名健康研究对象的心血管危险因素，计算Framingham危险评分积分值，估测未来10年冠心病的发生风险，并根据发生风险的大小将研究对象分为低危组（10年冠心病发生风险〈10％），中危组（10％～20％）和高危组（10年冠心病发生风险〉20％）；并根据年龄将研究对象分为5组：≤44岁组，45—54岁组，55—64岁组，65—74岁组和≥75岁组。以Cockcroft-Gault公式（GFRCG），简化MDRD公式（GFRMDRD1）以及改良MDRD公式（GFRMDRD2）估测GFR，比较不同危险分组间的GFR，计算Framingham危险评分积分值与GFR的相关性。结果低危组GFRCG，GFRMDRD1及GFRMDRD2分别为（103±27）ml·min^-1·（1.73m^2）^-1，（109±22）ml·min^-1·（1.73m^2）^-1及（134±27）ml·min^-1·（1.73m^2）^-1；中危组GFRCG，GFRMDRD1及GFRMDRD2[（84±24）ml·min^-1·（1.73m^2）^-1，（101±27）ml·min^-1·（1.73m^2）^-1，（124±33）ml·min^-1·（1.73m^2）^-1]均比低危组低（均P〈0.01）；高危组GFRCG，GFRMDRD1及GFRMDRD2[（71±15）ml·min^-1·（1.73m^2）^-1，（88±15）ml·min^-1·（1.73m^2）^-1，（109±18）ml·min^-1·（1.73m^2）^-1]均低于中危组（均P〈0.01）。Framingham危险评分积分值与GFR呈显著负相关，相关系数为-0.586（GFRCG，P〈0.01），-0.449（GFRMDRD1及GFRMDRD2，P〈0.01）。结论健康人群心血管危险因素与GFR存在负相关，危险因素的项目越多，程度越重，Framlngham危险评分积分值越高，GFR越低。Objective To evaluate the relationship between cardiovascular risk factors and glomerular filtration rate in healthy population. Methods A community-based cross-sectional study was conducted in Shenyang. The Framingham sex-specific risk equation was employed to evaluate the cardiovascular risk factors of 501 healthy study objects, calculate Framingham risk score and estimate the risk of 10-year coronary heart disease （CHD）. A total of 501 study subjects were then divided into 3 groups according to 10-year CHD risk： low risk group （ 〈 10% ）, moderate risk group （ 10% -20% ） and high risk group （ 〉20% ）. Study subjects were also divided into 5 groups according to age： ≤44 years old; 45 -54 years old; 55 -64 years old; 65 -74 years old and ≥ 75 years old. The Cockcroft-Gauh equation （ GFRCG ）, abbreviated MDRD equation （ GFRMDRD1 ） and modified MDRD equation （ GFRMDRD2 ） were used to estimate glomerular filtration rate （GFR）. Glomerular filtration rate （GFR） were compared among different risk groups and correlation coefficients between Framingham risk score and glomerular filtration rate calculated. Results GFRCG, GFRMDRD1 and GFRMDRD2 in the low risk group was [（103±27）ml·min^-1·（1.73m^2）^-1,（109±22）ml·min^-1·（1.73m^2）^-1及（134±27）ml·min^-1·（1.73m^2）^-1].Compared with the low risk group, GFRCG, GFRMDRD1 and GFRMDRD2 in moderate risk group all decreased [（84±24）ml·min^-1· （1.73 m^2）^-1, （101 ±27）ml ·min^-1· （1.73 m^2）^ -1, （124±33）ml· min^-1· （ 1.73 m^2 ） ^-1 , all P 〈 0. 01 ] . GFRCG, GFRMDRD1 and GFRMDRD2 in the high risk group all decreased [（71±15）ml·min^-1·（1.73 m^2）^ -1, （88±15） ml·min^-1· （1.73 m^2）^ -1, （109±18）ml·min^-1· （1.73 m^2）^ -1, all P 〈0. 01 ]. The GFRCG, GFRMDRD1 and GFRMDR2 in the high risk group all decreased compared with the moderate risk group （ P 〈 0. 05 ）. There was a significantly inverse correlation between Framingham risk score and G

关 键 词：肾小球滤过率 心血管疾病 临床研究 患者 

分 类 号：R686[医药卫生—骨科学]