老年冠心病无症状心肌缺血和心绞痛并发慢性左心室收缩功能不全患者肾小球滤过率估测值与血红蛋白浓度的相关性  

Study of relationship between estimated glomerular filtration rate and plasma hemoglobin concentration in elderly patients with chronic left ventricular systolic dysfunction due to coronary heart disease silent myocardial ischemia or angina pectoris

作　　者：李刚[1] 张灿晶 王志华[1] 马弗愚 汪洋[1] 

机构地区：[1]重庆医科大学附属第一医院老年科心血管病组,重庆400016 [2]重庆市西郊医院功能检查科

出　　处：《中国老年学杂志》2010年第20期2889-2892,共4页Chinese Journal of Gerontology

基　　金：重庆市科委自然科学基金计划资助项目〔渝科发计字(2007)25号CSTC;2007BB5276〕;重庆市卫生局医学科学技术研究项目〔渝卫教2004(53)04-2-1542009-2-290〕

摘　　要：目的探讨老年冠心病无症状性心肌缺血和心绞痛并发慢性左心室收缩功能不全(CLVSD)患者肾小球滤过率估测值(eGFR)与血红蛋白(Hb)浓度的相关性。方法收集≥60岁冠状动脉造影证实冠心病无症状性心肌缺血和心绞痛患者235例,其中,超声心动图检测左心室射血分数(LVEF)<50%110例归为CLVSD组〔LVEF(37.72±5.68)%〕;LVEF≥50%余125例归为非CLVSD组〔LVEF(60.25±5.56)%〕。上述两组据eGFR分别再分为eGFR<60 ml.min-1.1.73 m-2组与eGFR≥60 ml.min-1.1.73 m-2组,回顾性分析此两组间Hb浓度差异。结果与非CLVSD组比较,CLVSD组Hb浓度显著增高〔(114.57±23.34)和(120.92±18.92)g/L,P<0.05〕。LVEF与Hb浓度显著负相关(r=-0.18,P<0.05)。CLVSD组中,与≥60 ml.min-1.1.73 m-2组比较〔(84.36±16.80)ml.min-1.1.73 m-2〕,eGFR<60 ml.min-1.1.73 m-2组〔(46.28±11.90)ml.min-1.1.73 m-2〕,Hb浓度显著降低〔(123.12±18.98)和(112.79±16.10)g/L,P<0.05〕,eGFR与Hb浓度显著正相关(r=0.24,P<0.05)。在非CLVSD组中,与eGFR≥60 ml.min-1.1.73 m-2组比较〔(90.39±20.75)ml.min-1.1.73 m-2〕,eGFR<60 ml.min-1.1.73 m-2组〔(44.11±12.44)ml.min-1.1.73 m-2〕Hb浓度亦显著降低〔(116.47±20.63)和(108.10±30.08)g/L,P<0.05〕,eGFR与Hb浓度亦显著正相关(r=0.18,P<0.05)。结论老年冠心病无症状性心肌缺血和心绞痛并发CLVSD患者Hb浓度显著增高,Hb浓度与LVEF显著负相关,而与eGFR显著正相关。Objective To study the relationship between estimated glomerular filtration rate（eGFR） and plasma hemoglobin（Hb） concentration in elderly patients with chronic left ventricular systolic dysfunction（CLVSD） due to coronary heart disease silent myocardial ischemia or angina pectoris.Methods 235 patients aged 60 years and older with angiography confirmed coronary heart disease silent myocardial ischemia or angina pectoris were collected in our hospital.Among them,110 patients with left ventricular ejection fraction（LVEF）50%（（37.72±5.68）%）measured by M-mode echocardiography were divided into CLVSD group,the other 125 patients with LVEF≥50%（（60.25±5.56）%） were divided into non-CLVSD group.Patients in the above two groups were divided into eGFR60 ml·min-1·1.73 m-2 group and eGFR≥60 ml·min-1·1.73 m-2 group respectively.Hb concentration was analyzed retrospectively between eGFR60 and ≥60 ml·min-1·1.73 m-2 groups.Results Plasma Hb concentration was significantly increased in CLVSD group compared with non-CLVSD group（（120.92±18.92） vs（114.57±23.34） g/L,P0.05）,and Hb concentration was negatively related to LVEF（r=-0.18,P0.05）.In CLVSD group,Hb concentration was significantly decreased in eGFR60 ml·min-1·1.73m2 group（（46.28±11.90） ml·min-1·1.73 m-2） compared with eGFR≥60 ml·min-1·1.73 m-2 group（（84.36±16.80） ml·min-1·1.73 m-2）（（112.79±16.10） vs（123.12±18.98） g/L,P0.05）;and Hb concentration was positively related to eGFR significantly（r=0.24,P0.05）.Meanwhile,in non-CLVSD group,Hb concentration was also significantly decreased in eGFR60 ml·min-1·1.73 m-2group（（44.11±12.44） ml·min-1·1.73 m-2）compared with eGFR≥60 ml·min-1·1.73 m-2group（（90.39±20.75） ml·min-1·1.73 m-2）（（108.10±30.08） vs（116.47±20.63） g/L,P0.05）;and Hb concentration was also positively related to eGFR significantly（r=0.18,P0.05）.Conclusions Hb concentration is significantly increased in elderly patients with CL

关 键 词：慢性心力衰竭 冠心病 无症状心肌缺血 心绞痛 肾小球滤过率 血红蛋白浓度 

分 类 号：R541.6[医药卫生—心血管疾病]