血清胱抑素C、尿微量清蛋白/尿肌酐比值与冠状动脉病变严重程度相关性分析  

Correlation between serum cystatin C and urinary microalbumin/urine creatinine with severity of coronary artery lesions

作　　者：刘彬彬 张月兰[1] LIU Binbin;ZHANG Yuelan(Department of Cardiology,First Affiliated Hospital of China Medical University,Shenyang,Liaoning 110001,China)

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：《重庆医学》2021年第22期3887-3891,共5页Chongqing medicine

摘　　要：目的探讨血清胱抑素C(Cys C)水平、尿微量清蛋白/尿肌酐比值(UACR)与冠状动脉病变严重程度的相关性。方法选择2019年12月至2020年12月该院心内科住院并行冠状动脉造影确诊为CHD的患者300例为研究对象,根据SYNTAX评分、冠状动脉病变支数进行分组。比较各组间肾功能指标肾小球滤过率(eGFR)、Cys C水平及UACR,分析冠状动脉病变支数与肾功能的相关性。结果各组间实验室检查生化指标、血肌酐、eGFR水平比较差异无统计学意义(P>0.05)。与低危组比较,中危组、高危组Cys C、UACR水平明显升高,且高危组变化更明显,差异有统计学意义(P<0.05)。三支病变组血肌酐、eGFR水平与其余两组比较差异有统计学意义(P<0.05),但单支病变组与两支病变组差异无统计学意义(P>0.05)。随着冠状动脉病变支数的增多,Cys C、UACR水平逐渐升高,差异有统计学意义(P<0.05)。Cys C(OR=1.299,95%CI:1.152~1.464,P<0.05)和UACR(OR=1.022,95%CI:1.015~1.029,P<0.05)是冠状动脉多支病变的独立危险因素。Cys C的曲线下面积(AUC)为0.630(95%CI:0.567~0.693,P<0.05),UACR的AUC为0.818(95%CI:0.771~0.865,P<0.05),二者具有良好区分度。结论Cys C、UACR水平能够早于血肌酐和eGFR反映冠状动脉病变的严重程度。Objective To investigate the correlation between serum cystatin C(Cys C)and urinary albumin/urine creatinine ratio(UACR)with severity of coronary artery lesions.Methods Three hundreds inpatients with coronary heart disease(CHD)definitely diagnosed by coronary angiography in the cardiology department of this hospital from December 2019 to December 2020 were selected as the study subjects and grouped according to the SYNTAX score and number of coronary arterial lesion branches.The levels of renal functions indexes such as eGFR,CysC and UACR were compared among the groups.The correlation between number of coronary arterial lesion branches and renal function was analyzed.Results The levels of biochemical indexes,blood creatinine and eGFR had no statistical difference among the groups(P>0.05).Compared with the low risk group,the Cys C and UACR levels in the middle risk group and high risk group were significantly increased,moreover the change in the high risk group was more significant,and the differences were statistically significant(P<0.05).The blood creatinine and eGFR levels had statistical difference between the three branches lesion group with the other two group(P<0.05),which had no statistical difference between the single branch lesion group and double branches lesion group(P>0.05).With the increase of coronary arterial branches lesion number,the Cys C and UACR levels were gradually increased,and the difference was statistically significant(P<0.05).Cys C(OR=1.299,95%CI:1.152-1.464,P<0.05)and UACR(OR=1.022,95%CI:1.015-1.029,P<0.05)were the independent risk factors of coronary multivessel lesions.The area under the ROC curve(AUC)of CysC was 0.630(95%CI:0.567-0.693,P<0.05),AUC of UACR was 0.818(95%CI:0.771-0.865,P<0.05).The both had good distinction degree.Conclusion The Cys C and UACR levels can earlier reflect the severity of coronary artery disease than serum creatinine and EGFR.

关 键 词：冠心病 SYNTAX评分 尿微量清蛋白/尿肌酐 肾功能 

分 类 号：R541.4[医药卫生—心血管疾病]