高龄急性冠状动脉综合征患者冠状动脉狭窄与肾功能的相关性

Correlation between coronary stenosis and renal function in advance-aged patients with acute coronary syndrome

目的研究高龄急性冠状动脉综合征(ACS)患者的冠状动脉狭窄程度与肾功能指标的相关性。方法连续入选536例年龄≥80岁的ACS患者,根据Gensini评分将患者分为对照组66例,轻度狭窄组141例,中度狭窄组167例,重度狭窄组162例。比较各组肾功能指标与Gensini评分的相关性。结果与对照组比较,轻度狭窄组、中度狭窄组和重度狭窄组患者随着冠状动脉狭窄程度的加重,血清肌酐、尿素和胱抑素C水平明显升高(P<0.01),估算肾小球滤过率(eGFR)明显降低(P<0.05)。血清肌酐(r=0.1 93,P=0.000)、尿素(r=0.194,P=0.000)、胱抑素C(r=0.295,P=0.000)与Gensini评分呈正相关,eGFR(r=-0.160,P=0.001)与Gensini评分呈负相关。结论年龄≥80岁ACS患者冠状动脉狭窄程度与肾功能指标密切相关。血清胱抑素C水平最敏感。

Objective To study the correlation between coronary stenosis and renal function in pa- tients with acute coronary syndrome（ACS） at the age ≥80 years. Methods Five hundred and thirty-six ACS patients at the age ≥80 years were divided into control group（n=66） ,mild steno- sis group（n=141）,moderate stenosis group（n=167）,and severe stenosis group（n=162） accord- ing to their Gensini score. Correlation between their renal function indications and Gensini score was compared. Results The serum creatinine, urea and cystatin C levels were higher （P〈0.01） and the glomerular filtration rate was lower（P〈0.05） when the coronary stenosis was aggrava- ted in the 4 groups. The serum creatinine, urea and cystatin C levels were positively correlated while the glomerular filtration rate was negatively correlated with the Gensini score（r=0. 193, P=0.000;r=0.194,P=0.000;r=0.295,P=0.000;r=--0.160,P=0.001）.Conclusion Coro- nary stenosis is closely correlated with renal function indications,especially with the serum eysta- tin C level,in ACS patients at the age ≥80 years.