老年冠心病患者估计肾小球滤过率与SYNTAX积分的相关性  

Association of estimated glomerular filtration rate with SYNTAX score in old patients with coronary heart disease

作　　者：俞鑫[1] 孙宇姣[1] 齐国先[1] 

机构地区：[1]中国医科大学附属第一医院心内科,沈阳110001

出　　处：《中国医师进修杂志》2016年第3期202-205,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨在老年冠心病患者中由血清胱抑素c联合血肌酐计算的估计肾小球滤过率（eGFR）与SYNTAX积分的关系。方法连续选取行冠状动脉造影检查的老年冠心病患者256例，通过以血清肌酐和胱抑素C为基础的BIS．2方程计算eGFR，并计算SYNTAX积分。应用多元线性回归分析各临床资料与SYNTAX积分之间的关联，应用有序的Logistic回归分析各临床资料与SYNTAX积分危险分层的相关性。结果肾功能正常[eGFR≥90ml／（min·1．73m2），110例]、轻度肾功能不全[60ml／（min·1．73m2）≤eGFR〈90ml／（min·1．73m2），98例]、中重度。肾功能不全[eGFR〈60ml／（min·1．73m2），48例]患者随着肾功能的减低，SYNTAX积分升高[（15．42±9．65）、（25．24±8．34）、（33．73±10．15）分]，差异有统计学意义（P〈0．01）。多元线性回归分析结果显示，eGFR与SYNTAX积分呈负相关（r=-0．457，P〈0．01）。有序的Logistic回归分析结果显示，eGFR是SYNTAX积分的独立预测因子（r=-0．059，P〈0．01）。结论eGFR是老年冠心病患者SYNTAX积分的独立预测因子，并且与SYNTAX积分呈负相关。这可能是。肾功能不全的老年患者发生心血管事件风险更高的原因。Objective To explore the association between estimated glomerular filtration rate （eGFR） based on creatinine and cystatin C and the SYNTAX score in old patients with coronary heart disease. Methods Two hundred and fifty-six consecutive old patients with coronary heart disease were included in this study. The patients were angiographically diagnosed with coronary heart disease between January 2013 and April 2014 at the Department of Cardiology.eGFR was caculated by using BIS2 equation based on creatinine and cystatin C.SYNTAX score was caculated by SYNTAX score algorithm. Multiple linear regression and ordinal logsitic regreesion was used to analyze the association between eGFR and SYNTAX score. Results In patients with normal of renal function [eGFR ≥90 ml/（min. 1.73 m：）, 110 patients], mild renal insufficiency [60 ml/（min . 1.73 m2） ≤ eGFR 〈 90 ml/（min . 1.73 m2）, 98 patients], midrange and severe renal insufficiency[eGFR 〈 60 ml/（min. 1.73 m2）, 48 patients], with the decrease in renal function of patients, SYNTAX score increased： （15.42 ± 9.65）, （25.24 ±8.34）, （33.73 ± 10.15） scores, P 〈 0.01. eGFR was an independent predictor of SYNTAX score （r = -0.059, P 〈 0.01）.eGFR was negatively correlated with SYNTAX score （r = -0.457, P 〈 0.01）. Conclusions eGFR is an independent predictor of SYNTAX score and negatively correlated with SYNTAX score in old patients with coronary heart disease. This might be helpful to explain the increased risk of coronary heart disease events and mortality in old patients with renal dysfunction.

关 键 词：肾小球滤过率 冠状动脉疾病 SYNTAX积分 

分 类 号：R541.4[医药卫生—心血管疾病]