老年患者慢性肾功能不全与冠状动脉钙化积分的相关性  

Association between chronic kidney dysfunction and coronary artery calcification score in elderly patients

作　　者：颜利求[1] 曹绪芬[1] 郑晔[1] 郭楠[1] 熊立新[2] 曹艳超[1] 赵世龙[1] 郭艳芬[1] 韩立宪[1] 

机构地区：[1]河北省沧州市中心医院心内科,061001 [2]河北省沧州市中心医院医学影像科,061001

出　　处：《中华老年医学杂志》2014年第2期150-153,共4页Chinese Journal of Geriatrics

摘　　要：目的分析老年患者慢性肾功能不全与冠状动脉（冠脉）钙化积分（CAcs）的相关性。方法前瞻性连续性入选2006年1月至2010年12月因疑诊冠心病于我院行64层螺旋CT的老年患者795例，应用Agatston方法计算CACS，应用简化MDRD公式计算估算肾小球滤过率（eGFR）。根据CACS将患者分为4组：无冠脉钙化组（CAcs=O）、低冠脉钙化组（CACS1～100）、中冠脉钙化组（CACS101～400）以及高冠脉钙化组（CACS〉400）。通过有序Logistic回归分析慢性肾功能不全与冠状动脉钙化积分的相关性。结果高冠脉钙化组患者年龄大（F=4．99，P=0．002），eGFR低（F=10．16，P〈O．001），C反应蛋白水平高（F=39．36，P〈0．001），高血压（X2=18．59，P〈0．001）、糖尿病（X2=14．03，p=0．003）的患病率高。有序Logistic回归分析表明年龄、高血压、糖尿病、C反应蛋白及eGFR是冠状动脉钙化的独立危险因素。结论年龄、高血压、糖尿病、C反应蛋白及eGFR是老年患者冠状动脉钙化的独立危险因素。Objective To investigate the association between chronic kidney dysfunction and coronary artery calcification score（CACS） in the elderly. Methods We prospectively studied 795 consecutive elderly patients with clinically suspected coronary artery disease who underwent 64- multideteetor row computed tornography coronary angiography from January 2006 to December 2010. CACS was quantified using Agatston method, eGFR was calculated by the simplified modification of diet in renal disease（MDRD）equation. Patients were divided into four groups according to CACS as follows： No CACS（CACS = 0）, low CACS（0〈CACS≤100）, medium CACS（100〈CACS≤400） and high CACS（CACS〉400）. Ordinal logistic regression was used to analyze the association of chronic kidney dysfunction with CACS. Results Patients with higher CACS were older （F=4.99, P%0.01）, had lower eGFR（F= 10. 16,P〈.0. 001）and higher level of C-reactive protein（F=39.36,P d0. 001）, and were more likely to have a history of hypertension（X2 =18.59,P〈0. 001）and diabetes （Z2 = 14.03 ,P〈0.01）than patients without coronary artery calcification（CAC） or with lower CACS. Ordinal logistic regression showed that age, hypertension, diabetes, C reactive protein and eGFR were independent risk factors for CAC. Conclusions Age, hypertension, diabetes mellitus, C-reactive protein and eGFR were independent risk factors for CAC in elderly patients.

关 键 词：肾功能不全 慢性 冠状动脉疾病 体层摄影术 螺旋计算机 

分 类 号：R692.5[医药卫生—泌尿科学] R543.3[医药卫生—外科学]