冠状动脉病变程度与冠心病患者肾小球滤过率的相关分析

Correlation analysis of the severity of coronay artery stenosis with estimated glomerular filtrationrate in patients with coronary heart disease

目的探索冠状动脉狭窄程度、病变长度与冠心病患者肾小球滤过率（eGFR）的相关性。方法总结分析河南省胸科医院收治的298例冠心病患者的冠状动脉造影结果，根据冠状动脉狭窄程度计算其Gensini积分，依据中国人校正简化MDRD方程估算患者eGFR，比较分析患者的Gensini积分、冠状动脉病变长度与患者eGFR的相关性。结果52．3％冠心病患者eGFR〈90mE／（min×1．73m^2）。随患者冠状动脉狭窄程度、病变长度的增加，患者肾功能减退的发生率增加，eGFR比较差异有统计学意义。控制年龄、高血压病、糖尿病等因素后，冠状动脉狭窄程度与病变长度及eGRF存在相关性（分别为r=-0．164，P=0．038和r=-0．130，P=0．046）。结论冠心病患者肾功能减退发生率高；冠状动脉的病变程度与肾小球滤过率相关，可对冠心病患者的肾功能做初步评估。

Objective To investigate the relationship between the severity of coronary artery ste- nosis, length of lesion and the estimated glomerular filtration rate （eGFR） in patients with coronary heart disease. Methods Two hundred and ninety-eight patients who underwent selective coronary angiography were divided into three groups according to the simplified MDRD equation, eGFR 〉 90 ml/（ rain× 1.73 m^2 ） was defined as normal renal function, and eGFR from 60 to 89 mL/（ rain × 1.73 m^2 ） and eG- FR less than 60 ml/（rain × 1.73 m^2 ） were defined as mild impaired renal function and severe renal dys- function, respectively. The correlation of the severity or length of coronary artery stenosis with the esti- mated glomerular filtration rate was analyzed. Results One hundred and fifty-six patients （52. 3% ） showed the eGFR of less than 90 ml/（ min × 1.73 m^2）. Patients with more severe and longer coronary ar- tery stenosis had higher incidence rate of renal dysfunction, the level of average eGFR tended to be de- creased. After eliminating the effects of age, hypertension, diabetes, the severity and length of coronary artery stenosis was negatively correlated with the level of eGFR（ r = -0. 164,P = 0. 038 and r = -0. 130, P = 0. 046）. Conclusions There is higher incidence of renal dysfunction in patients with coronary heart disease. The severity and length of coronary artery stenosis is correlated with the eGFR. The severity and length of coronary artery stenosis can be used to initially evaluate the renal function of patients with coro- nary heart disease.