老年慢性心力衰竭患者尿白蛋白水平变化及临床意义

Variation and Clinical Significance of Urinary Albumin Levels in Elderly Patients with Chronic Heart Failure

目的:研究老年慢性心力衰竭(CHF)患者微量白蛋白尿(MAU)的患病情况及与心、肾功能的关系。方法:对90例老年(年龄≥60岁)CHF患者、66例心功能代偿的老年心脏病患者和29例老年对照者进行尿白蛋白与尿肌酐比值(ACR)测定,并与常规心、肾功能指标进行相关分析。结果:CHF患者MAU患病率为53.3%,较对照组娃著升高(P<0.05)。在CHF组,ACR与纽约心脏病协会(NYHA)评分(r=0.467,P<0.01)。糖尿病史(r=0.417,P<0.05)和C反应蛋自(r=0.352.P<0.05)相关,而与其它心、肾功能指标无关。结论:老年CHF患者MAU检出率极高且ACR与心衰程度相关。

Objective ：To investigate the prevalence of and the association with heart and renal function in elderly patients with chronic heart failure （CHF）. Methods： In 90 elderly patients （ ≥60 years old） with CHF, 66 elderly patients with heart disease but compensated heart function and 29 control elderly patients, urinary albumin/creatinine ratio （ACR） was determined and correlated with typical heart and renal function parameters. Results： In 53. 3% （95% confidence interval 43.0% -63.6% ） of the chiefly CHF patients, microalburninuria was present, which is significantly higher than in the control patients （P 〈0. 05 ）. The levels of serum cretinine, ACR and calculated glomerular filtration rate were significantly different in CHF subjects compared with that in control subjects （ P 〈 0. 01, P 〈 0. 01 and P 〈0. 05. respectively） too. And the level of ACR was positively related with New York Heart Association class score （r = 0. 467, P 〈 0. 01 ）, the history of diabetic （r = 0. 417. P 〈 0. 05 ） and C - reactive protein（ r = 0. 352. P 〈 0. 05 ） in CHF subjects. However, we found no significant association between ACR and renal function. Serum creatinine instead of ACR and prevalence of microalbuminuria was different between CHF subjects and compensated heart function subjects. Conclusion： It was shown that there was a high prevalence of microalbuminuria in elderly patients with CHF. The level of ACR was correlated with the seventy of heart failure.