慢性肾脏病冠状动脉钙化发生率及预后评估

目的探讨慢性肾脏病（CKD）冠状动脉钙化发生率及其在预后评估中的应用。方法测定136例CKD患者及50例同期健康体检者血钙（Ca）、血磷（P）水平，并采用多层螺旋CT（MSCT）检测所有观察对象冠状动脉钙化积分情况。比较不同组间患者的冠状动脉钙化及主要心脏不良事件（MACE）发生情况。结果与对照组比较，三组不同CKD分期患者的冠状动脉钙化率、重度钙化率、血磷及钙磷乘积均明显升高（P〈0．05）；且随着CKD病情程度的增加，患者冠状动脉钙化率、重度钙化率、钙磷乘积均依次增加（P〈0．05）；随着透析治疗时间的延长，冠状动脉钙化率、重度钙化率均呈上升趋势（P〈0．05）；随访1年，钙化组MACE发生率为16．9％，显著高于非钙化组为5．6％（P〈0．05）。结论CKD患者冠状动脉钙化发生率较高，尤其是长期维持性透析患者，且冠状动脉钙化程度与CKD患者的预后有关。

Objective To explore the incidence of coronary calcification in patients with chronic kidney disease （ CKD ） , and its prognosis evaluation value at a single center. Methods The blood calcium （ Ca ） and phosphate （ P ） in 136 CKD patients and 50 healthy persons were detected, and the coronary calcification score were measured by multi-slice spiral computed tomography （ MSCT ） . Result Compared with health controls, incidence of coronary calcification and severer coronary calcification, level of P and Ca-P product were significantly higher in CKD patients of different stages, and with the severity aggravating of CKD, incidence of coronary calcification and severer coronary calcification, level of Ca-P product were increased （ P〈0.05 ） . The incidence of coronary calcification and severer coronary calcification increased with the dialysis duration （ P〈0.05 ） . During 1 year follow-up, the incidence of MACE in calcification group was 16.9%, significantly higher than that of non- calcification group 5.6% （ P〈0.05 ） . Conclusions From our single center＇ s experience,patients with CKD has higher incidence of coronary calcification, especially for calcification is correlated with the prognosis of CKD. the long-term support dialysis patients, and the degree of coronary