肾小球滤过率与老年患者冠脉病变程度的关系研究

Relationship between glomerular filtration rate and severity of coronary lesions in elderly patients

目的探讨肾小球滤过率(GFR)与老年患者冠脉病变程度的关系。方法选取老年患者240例为研究对象,根据冠脉造影结果计算冠脉病变范围积分和冠脉狭窄程度积分。采用适合中国的改良简化MDRD公式估算GFR(eGFR)将研究对象分为肾功能正常组、肾功能轻度减低组和肾功能中重度减低组,分析eGFR与老年患者冠脉范围积分、冠脉狭窄积分的关系。结果轻度减低组和中重度减低组的年龄明显大于正常组(P<0.05),表明随着年龄的增长,肾小球滤过率呈下降趋势。中重度减退组患者的男性比例比肾功能正常组大(P=0.002),但肾功能正常组与轻度减低组、轻度减低组与中重度减低组比较差异无统计学意义(P均>0.05)。肾功能中重度下降组冠脉病变范围积分、冠脉狭窄程度积分明显高于肾功能正常组(P<0.05)。eGFR与冠脉病变范围积分和冠脉狭窄程度积分均呈负相关(r=-0.149,P=0.021和r=-0.166,P=0.01)。结论在老年患者中,eGFR与冠脉病变程度呈负相关关系。

Objective To explore the relationship between glomerular filtration rate （GFR） and severity of coronary lesions in elderly patients. Methods Two hundred and forty elderly patients were selected as research sub- jects, and according to the results of coronary angiography the coronary lesions integral and coronary stenosis integral were calculated. The modified abbreviated MDRD equation suitable for our country was used to estimate GFR （eG- FR）. According to eGFR of the study subjects were divided into normal renal function group, mild renal insufficiency group and moderate to severe renal insufficiency groups. The relationship between eGFR and coronary lesions integral or coronary stenosis integral were analyzed. Results The age in mild renal insufficiency group and moderate to severe renal insugieieney group were higher than that in normal renal function group （ P 〈 0. 05 ） , and showed that with the growth of the age, the glomenalar filtration rate declined. The proportion of males in moderate to severe renal insuffi- ciency groups was higher than that in normal renal function group （P = 0. 002）. But there was no significant difference between the normal renal function group and mild renal insufficiency group or between mild renal insufficiency group and moderate to severe renal insufficiency groups （ all P 〉 0. 05）. The coronary lesions integral and coronary stenosis in- tegral in the moderate to severe renal insufficiency group were greater than that in the normal renal function group（P 〈 0. 05 ）. eGFR was negative correlated with coronary lesions integral（ r = - 0. 149 ,P = 0. 021 ） or coronary stenosis in- tegral （ r = - 0. 166,P = 0. 01 ）. Conclusion In elderly patients, there is negative correlation between eGFR and se- verity of coronary lesions.