肾功能不全对冠脉支架治疗老年冠心病患者预后的影响  

Influence of renal insufficiency on prognosis of patients with coronary heart disease undergoing coronary stenting

作　　者：李涛[1] 

机构地区：[1]兰州军区兰州总医院心血管内科,甘肃兰州730050

出　　处：《临床军医杂志》2014年第6期554-556,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨肾功能不全(RI)对冠脉支架治疗老年冠心病患者(CHD)预后的影响。方法选择在我院行冠状动脉支架治疗的老年CHD患者200例,根据患者的肾小球滤过率(eGFR)将患者分为中重度RI(A)组和正常或轻度RI(B)组,分析RI对冠脉支架治疗老年冠心病患者预后的影响。结果 A组术前用冠状动脉造影来评定冠状动脉狭窄程度的TIMI血流分级为0级者明显高于B组(χ2=13.928,P<0.05);A组TIMI血流分级为1级者0例,明显低于B组(χ2=5.407,P<0.05);两组TIMI血流分级为2级和3级的患者例数比较差异无统计学意义(P>0.05)。A组患者单支病变例数明显高于B组(χ2=12.990,P<0.05),3支及以上病变例数显著低于B组(χ2=11.216,P<0.05),双支病变例数比较差异无统计学意义(P>0.05)。两组患者病变类型比较差异均无统计学意义(P>0.05)。住院期间A组的MACE和心源性死亡的发生率明显高于B组(χ2=5.162、5.347,P<0.05),全因死亡和心肌梗死的发生率差异无统计学意义(P>0.05)。随访1年期间两组患者的全因死亡、主要心脏(冠脉)不良事件(MACE)、心肌梗死和心源性死亡发生率比较差异无统计学意义(P>0.05)。结论中重度的RI对冠脉支架治疗老年冠心病患者预后的影响明显高于轻度RI或正常的患者,改善患者的肾功能有利于提高此类患者的预后。Objective To investigate the influence of renal insufficiency on the prognosis of the patients with coronary heart disease （CHD） undergoing coronary stenting. Methods Two hundred patients with CHD undergoing coronary stenting in our hospital were enrolled in the study and were divided into Group A （ moderate or severe renal dysfunction） and Group B （ normal renal function or mild renal insufficiency） according to their estimated glomerular filtration rate （eGFR）. The influence of renal insufficiency on the prognosis of the patients was analyzed. Results The patients with TIMI flow of grade 0 in Group A significantly more than those in Group B （χ^2 = 15. 928, P 〈 0.05 ） ; there was none with TIMI flow of grade 1 in Group A, significantly lower than that in Group B （ χ^2 = 5. 407, P 〈 0.05 ） ; as for TIMI flow of grade 2 and 3, there were no significant differences between the two group（ P 〉 0.05 ）. Patients with single vessel lesion were significantly more in Group A than in Group B （ χ^2 = 12. 990, P 〈 0.05 ） ; those with three or more vessel lesions were significantly less Group A than in Group B （ χ^2 = 11. 216, P 〈 0.05 ） ; those with double vessel lesions were of no significant difference between the two group （ P 〉 0.05 ）. There was no significant difference in lesion type between the two group （P 〉0.05）. The incidences of the patients suffering from main adverse cardiac event （MACE） and cardiac death were significantly higher in Group A than in Group B during hospitalization （ χ^2 = 5. 162, 5. 347 ; P 〈 0.05 ） , and the incidences of allcause mortality and myocardial infarction were of no significant difference （ P 〉 0.05 ）. During one year＇ s follow-up, there were no statistically significant differences in the incidences of all-cause mortality, MACE, myocardial infarction and cardiac death between the two groups （P 〉 0.05）. Conclusion Severe renal insufficiency influences the prognosis of the patients with CHD undergoin

关 键 词：肾功能不全 冠脉支架治疗 冠心病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]