Gensini积分与肾功能水平的关系  

Correlation between severity of coronary artery stenosis and renal function in older people with coronary heart disease

作　　者：熊日新[1] 曾涛[1,2] 袁军[1] 黄宗燕[1] 王孟杰[1] 卢志红[1] 林英忠[1] 刘伶[1] 

机构地区：[1]广西壮族自治区人民医院心血管内科 广西冠心病研究所,南宁530021 [2]广西医科大学研究生学院

出　　处：《临床心血管病杂志》2017年第4期323-328,共6页Journal of Clinical Cardiology

基　　金：广西医药卫生自筹经费计划课题项目(No:Z2015310);广西科学研究与技术开发计划项目(No:桂攻科14124003-9)

摘　　要：目的:探讨老年冠心病患者的临床特点及冠状动脉(冠脉)病变程度与肾功能水平的相关性。方法:按时间顺序纳入2015-05-01-2016-04-30因"胸痛"行冠脉造影检查的老年患者为研究对象,入组冠心病患者357例,其中AMI组93例、UA组164例、SA组100例,另取50例同期冠脉造影阴性者为对照组。详细记录其临床特征及相关生化指标,运用Gensini积分方法计算冠脉病变程度。结果:AMI组logGS高于UA及SA组(1.74±0.28、1.48±0.42、1.34±0.51,P<0.001),且伴有偏高的血肌酐水平(95.3±31.1、83.6±22.8、86.4±22.2、76.1±15.9,P<0.001)。单因素分析提示logGS与低肾小球滤过率、糖耐量异常、吸烟均有关(P<0.01),多因素分析亦证实logGS与低肾小球滤过率相关性具有统计学意义(P<0.01),Logistic分析提示Gensini积分与老年冠心病患者的急性冠脉综合征发生率显著相关(OR=1.007,95%CI:1.001-1.013,P=0.023)。结论:65岁以上冠心病患者中,心肌梗死患者冠脉狭窄程度最重,且伴有轻度肾功能的损害。logGS与肾功能下降有关,且Gensini积分每增加1分,急性冠脉综合征发生率也随之增加1.007倍。Objective： To examine the correlation between the severity of coronary artery stenosis and renal dysfunction in older people with coronary heart disease. Method： The 357 patients with coronary heart disease were enrolled （AMI group, n=93; UA group, n=164; SA group, n=100）. The 50 patients with negative coro- nary angiography were enrolled as control. We calculated their Gensini score, and detected their clinical parameters. Result： In AMI group, LogGS were much higher than those of UA group and SA group （l. 74±0. 28, 1.48±0.42, 1.34±0.51,P〈0.001）, and serum creatinine level was higher than others（95.3±31.1, 83.6±22.8, 86. 4±22. 2, 76.1±15. 9,P〈0. 001）. General linear model analysis showed that there was significant correlation between logGS and low estimated glomerular filtration rate（P〈0.05）. Logistic regression showed that Gensini score also had a close correlation with the rate of acute coronary syndrome{OR = 1. 007, [95 % CI（1. 001-1.013）], P=0. 023}. Conclusion.. There is a significant correlation between Gensini score and estimated glomerular filtration rate level in older people with coronary heart disease. The patients with AMI got the higher Gensini score but lower estimated glomerular filtration rate. And with the severity of coronary artery stenosis increases, the rate of acute coronary syndrome events accompanies with increase.

关 键 词：冠心病 肾功能损害 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病]