肾小球滤过率与冠心病的相关性研究  

Correlation between glomerular filtration rate and coronary artery disease

作　　者：李其华[1] 韦金儒[1] 唐泉[1] 银建斌 蒋芳勇[1] 

机构地区：[1]柳州市人民医院心血管内科,广西柳州545001

出　　处：《海南医学》2015年第22期3304-3307,共4页Hainan Medical Journal

摘　　要：目的研究估测的肾小球滤过率（e GFR）与冠心病及冠状动脉狭窄程度的关系。方法纳入因高度疑诊冠心病行选择性冠状动脉造影的住院患者349例,根据e GFR水平分为三组,其中高e GFR组（e GFR≥90 ml/min·1.73 m）125例,中e GFR组（60 ml/min·1.73 m≤e GFR〈90 ml/min·1.73 m）118例,低e GFR组（e GFR〈60 ml/min·1.73 m）106例。冠心病的诊断标准为主要冠状动脉或其主要分支直径狭窄≥50%,冠状动脉狭窄程度的评估采用Gensini评分系统。比较各组患者临床特点、冠心病所占比例以及冠状动脉狭窄积分有无差异。采用双变量相关与多因素Logistic回归分析e GFR与冠心病及冠状动脉狭窄程度的相关性。结果与高e GFR组比较,中、低e GFR组冠心病比例增大,冠状动脉狭窄积分增加（P〈0.05）。双变量相关分析显示e GFR与冠心病和冠状动脉狭窄积分呈负相关关系（r值分别为-0.380、-0.315,P均〈0.05）。多因素Logistic回归分析显示e GFR降低与冠心病与冠状动脉狭窄程度有关,是影响冠心病发生以及冠状动脉狭窄程度加重的独立危险因素（OR值分别为1.450和1.374,95%CI分别为1.026～2.241和1.047～2.164,P〈0.05）。结论 e GFR与冠心病及冠状动脉狭窄程度显著相关,是影响冠心病发生及冠状动脉狭窄程度加重的独立危险因素。Objective To explore the correlation between glomerular filtration rate（e GFR） and coronary artery disease（CAD）, as well as between e GFR and coronary artery stenosis. Methods A total of 349 hospitalized patients undergoing coronary angiography were enrolled into this research, which were divided into three groups according to e GFR level： high e GFR group（e GFR≥90 ml/min·1.73 m, 125 cases）, moderate e GFR group（60 ml/min·1.73 m≤e GFR90 ml/min·1.73 m, 118 cases）, and low e GFR group（e GFR60 ml/min·1.73 m, 106 cases）. CAD was defined as over50% reduction of lumen diameter at least in one major coronary artery. The severity of coronary artery stenosis was defined by the Gensini score. The baseline clinical characteristics and coronary angiogram were compared among various groups. Bivariate correlation and multivariate logistic regression analysis were performed to analyze the correlation between e GFR and CAD, as well as between e GFR and coronary artery stenosis. Results Incidence of CAD,and Gensini score of coronary artery in moderate and low e GFR group were significantly higher than that in high e GFR group（P〈0.05）. Bivariate correlation analysis showed that e GFR was negatively correlated with CAD and Gensini score of coronary artery stenosis（r=-0.380 and r=-0.315, respectively, all P〈0.05）. Multivariate logistic regression analysis showed that e GFR was independent risk factor for CAD and coronary artery stenosis（OR=1.450, 95% CI：1.026～2.241 and OR=1.374, 95%CI： 1.047～2.164, respectively, all P〈0.05）. Conclusion e GFR is closely correlated with CAD and coronary artery stenosis. It serves as an independent risk factor for CAD and coronary artery stenosis.

关 键 词：肾小球滤过率 冠心病 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]