肾功能损害与冠心病的相关性探讨  

Investigation on the relationship between renal dysfunction and coronary heart disease

作　　者：刘世洁[1] 张建义[1] 

机构地区：[1]桂林医学院附属医院,广西桂林541001

出　　处：《山东医药》2011年第39期14-16,共3页Shandong Medical Journal

基　　金：广西壮族自治区卫生厅资助项目(Z2006203)

摘　　要：目的探讨肾功能损害与冠心病的关系。方法将263例冠心病患者按肾功能检测结果分为肾功能损害组(观察组)141例、肾功能正常组(对照组)122例。比较两组冠脉造影检查结果及空腹血糖、血脂、血压等冠心病相关危险因素。结果观察组3支冠脉病变发生率、冠脉弥漫性病变发生率、血管病变支数、冠脉病变积分均显著高于对照组(P均<0.01),3支冠脉病变者血清肌酐(SCr)及尿微量蛋白(MAU)水平显著高于1支病变者(P<0.01);SCr及MAU与冠脉病变程度、年龄、血糖、收缩压呈正相关,与左室射血分数呈负相关(P均<0.05)。结论冠心病伴肾功能损害者冠脉病变支数及病变积分显著增加,冠脉弥漫性病变及狭窄程度加重;保护肾功能、控制血压及血糖水平,注重保护靶器官是防治冠心病心血管事件的重要措施。Objective To evaluate the relationship between renal dysfunction and coronary heart disease.Methods The patients with coronary artery disease（n=263） were involved,in which 141 patients with renal dysfunction（observed group） and 122 patients with normal renal function（control group）.All patients were performed coronary angiography,and before that,those correlative dangerous factors for coronary heart disease were measured： the serum creatinine,microalbuminuria,fasting blood-glucose,triglycerides,total cholesterol,high density lipoprotein,low density lipoprotein,blood pressure.Results The incidence of triple-vessel lesions,diffuse lesions,number of lesion coronary artery and coronary artery score were higher significantly in observed group than those in control group（P0.01）,the mean level of serum creatinine（SCr） and microalbuminuria（MAU）were higher significantly in patients with triple-vessel lesions than those in patients with single-vessel lesion（P0.01）;the mean level of SCr and MAU were positively correlated with the degree of coronary artery disease,age,blood glucose,systolic blood pressure,and were negatively correlated with left ventricular ejection fraction（all P0.05）.Conclusions The coronary heart disease patients with renal dysfunction usually have more severe coronary artery stenosis,higher percentage of multiple-vascular disease,higher coronary artery score,higher percentage of coronary artery diffuse lesions;to protect renal function,control the level of blood pressure and blood sugar,and protect target organ are important to the keep out of coronary heart disease.

关 键 词：肾功能损害 冠状动脉性心脏病 冠状动脉造影 

分 类 号：R692[医药卫生—泌尿科学] R541.4[医药卫生—外科学]