432例同时行冠状动脉和肾动脉造影患者的临床总结

Clinical characteristics of 432 patients receiving coronary angiography and renal arteriography at the same time

目的分析同时行冠状动脉和肾动脉造影患者的临床特点、安全性及可行性。方法临床入选432例同时行冠状动脉和肾动脉造影的患者,根据肾动脉狭窄情况分成肾动脉正常组(A组)、肾动脉轻度狭窄组(B组)和肾动脉显著狭窄组(C组),比较分析各组患者的多项临床指标。结果本研究患者中,冠脉病变发生率为61.57%,其中单支病变22.45%,双支病变22.22%,三支病变16.90%,左主干病变5.32%;肾动脉狭窄发生率为25.93%,其中肾动脉轻度狭窄发生率为12.04%,显著狭窄13.89%。与A组相比较,C组的年龄、高血压比例、高脂血症比例、双支病变比例及三支病变比例均显著升高(P<0.05)。通过Logistic回归分析发现,年龄、冠脉病变程度、高脂血症均是发生肾动脉狭窄的独立预测因子(P<0.05)。结论在合并有冠心病、高脂血症的中老年患者中,临床需高度警惕肾动脉狭窄,尽早完善冠状动脉和肾动脉造影检查,以便及时发现和干预;本研究证实,两项检查可同时安全进行。

Objective To analyze the clinical characteristics, safety, and feasibility of coronary angiography and renal arteriography performed in 432 cases at the same time. Methods 432 patients underwent coronary angiography and renal arteriography at the same time were selected, and according to their stenosis of renal artery,divided into group A（ with normal renal artery）, group B （with mild stenosis of renal artery）, and group C （with obvious stenosis of renal artery）. Comparison and analysis were made in the clinical indexes among the groups. Results The incidence of coronary artery disease, the single branch lesion, double-branch lesion, three-branch lesion,left stem lesion, and renal artery stenosis was 61.57% ,22.45% ,22.22%, 16.90% ,5.32%, and 25.93%, respectively. The incidence of the mild and the obvious renal artery stenosis was 12.04% and 13.89% ,respectively. Compared with the indexes of group A, the age and the proportion ratios of hypertension, hyperlipidemia, double-branch lesion, and three-branch lesion increased significantly （P 〈 0.05 ）in group C. The multivariate Logistic regression analysis indicated that the independent predictors for the incidence of renal artery stenosis included age, the degree of coronary artery disease, and hyperlipidemia. Conclusions Among the middle aged and senile patients with coronary heart disease complicated with hyperlipidemia, prevention should be taken for the incidence of renal artery stenosis. The examination by renal arteriography and coronary angiography should be improved in order to take early discovery and intervention. This study indicates those two examinations can be safely performed at the same time.