老年人发生心血管事件与肾功能及尿蛋白的相关性分析

Correlation Analysis on Elderly Cardiovascular Events with Renal Function and Urine Protein

目的探讨老年人发生心血管事件与肾功能及尿蛋白的相关性。方法选择我院2012年1月至2012年12月就诊和健康查体的老年人共405例，根据肾小球滤过率（eGFR）将研究对象分为肾功能正常组[eGFR≥60mL／（min·1．73m^2）]和肾功能下降组[eGFR〈60mL／（min·1．73m^3）]；另外，根据研究对象的尿常规检查结果将其分为尿蛋白阴性组和尿蛋白阳性组。对患者进行至少为期3年的随访，分析老年人发生心血管事件与肾功能及尿蛋白的相关性。结果随访期间发生心血管事件75例，肾功能正常组发生心血管事件27例，发生率为10．2％（27／264），肾功能下降组发生心血管事件48例，发生率为34．0％（48／141），差异有统计学意义（x^2=34．547，P〈0．05）。尿蛋白阴性组发生心血管事件55例，发生率为15．2％（55／362），尿蛋白阳性组发生心血管事件20例，发生率为46．5％（20／43），差异有统计学意义（x^2=24．983，P〈0．05）。经多因素Cox回归分析表明，尿蛋白阳性、eGFR水平下降是心血管事件的独立危险因素。结论对于老年人群，加强肾小球滤过率及尿蛋白的监测，发现异常者及早进行干预，可减少心血管事件的发生。

Objective To explore the correlation of elderly cardiovascular events with renal function and urine protein. Methods A total of 405 elderly people were selected and divided into two groups according to the estimated glomerular filtration rate （eGFR）normal renal function group [eGFR ≥ 60 mL/（min. 1.73 m2）] and decreased renal function group [eGFR 〈 60 mL/（min, 1.73 m2）J. According to the urine routine results, all cases were divided into the negative urine protein group and positive urine protein group. All cases were followed up for 3 years, and the correlations of elderly cardiovascular events with renal function and urine protein were analyzed. Results 75 cases of cardiovascular events were found during follow-up, including 27 cases in normal renal function group （10.2%, 27/264）, and 48 cases in decreased renal function group （34.0%, 48/141）, with statistical difference （x^2 = 34.547, P 〈0.05）. 55 cases of cardiovascular events were found in negative urine protein group （15.2%, 55/362）, and 20 cases in positive urine protein group （46.5%, 20/43）, with statistical difference （X2 = 24.983, P 〈0.05）. Multivariate Cox regression analysis showed that positive urine protein and decreased eGFR level were the independent risk factors of cardiovascular events. Conclusions Elderly population should enhance the monitoring of glomerular filtration rate and urinary protein. Early intervention for abnormal population can reduce the incidence of cardiovascular events.