冠心病伴肾动脉狭窄的患病率及相关因素研究

The Prevalence and Predictors of Atherosclerotic Renal Artery Stenosis in Patients with Coronary Artery Disease(CAD)

目的探讨冠心病患者中肾动脉狭窄(ARAS)的患病率及其相关因素。方法228例冠脉造影患者同时行选择性双肾动脉造影检查,对临床资料和ARAS之间的关系进行单因素和多因素Logistic回归分析。结果228例患者中,ARAS患病率为19.7%;经冠脉造影证实的152例冠心病患者中,ARAS患病率为27.6%;51例冠心病合并颈动脉粥样斑块的患者中,ARAS患病率为49.0%。45例ARAS患者中,左肾动脉狭窄的患病率显著高于右肾动脉(P<0.05)。单因素分析表明,年龄、糖尿病、肾功能不全、颈动脉粥样斑块、冠心病是ARAS的预测因素。多元Logistic回归分析表明,仅年龄、颈动脉粥样斑块、冠脉三支病变是ARAS的独立预测因素。结论对于冠心病患者,尤其是年龄≥60岁及合并颈动脉粥样斑块的患者,冠脉造影后应常规行肾动脉造影,以便早期发现ARAS。

Objective To investigate the prevalence and predictors of atherosclerotic renal artery stenosis （ARAS） in CAD patients undergoing coronary angiography. Methods Selective renal angiography was performed immediately in 228 cases after coronary angiography. Univariate and multivariate logistic regression analysis were carried out on the clinic data and renal artery stenosis. Results In 228 cases undergoing coronary angiography, the prevalence of ARAS was 19.7%. The prevalence of ARAS was 27.6% in 152 CAD patients. In 51 CAD patients associated with carotid artery atherosclerostie plaques, the prevalence of ARAS was 49.0%. In 45 ARAS patients the incidence of left renal artery stenosis is significantly higher than that of the right rend artery stenosis （ P 〈 0.05）. Univariate analysis indicated that age, diabetes, renal insufficiency, carotid artery atherosclerostic plaques and CAD were the predictors of ARAS. Multivariate analysis indicated that age, carotid artery atherosclerostie plaques and coronary artery triple vessel lesions were identified as independent predictors of ARAS. Conclusions Renal angiography should be routinely performed in patients with coronary artery disease undergoing coronary angiography to identify ARAS in early, especially for patients older than 60 years with carotid artery atherosclerostie plaques.