老年急性冠状动脉综合征患者合并肾功能不全的诊治进展

Treatment Development of Geriatric Acute Coronary Syndrome Patients with Renal Insufficiency

急性冠状动脉综合征目前已有许多成熟有效的治疗手段,包括药物治疗、血运重建治疗和外科手术治疗等;但是对于合并肾功能不全的老年急性冠状动脉综合征患者,必须慎重选择治疗方式。一方面,慢性肾脏病造成的肾功能不全是急性冠状动脉综合征的独立危险因素,可以增加急性冠状动脉综合征的发病率和病死率;另一方面,肾功能不全明显限制了药物的应用和冠状动脉造影的开展。通过了解相关指南推荐及采取有效的预防手段,可以使患者获益最大化。现概述合并慢性肾脏病的急性冠状动脉综合征患者的背景与现状,列举了指南药物推荐,并讨论了血运重建治疗的顾虑与相应预防手段,为临床工作提供参考。

There are currently several mature and effective treatment methods for acute coronary syndrome （ ACS） ,including medical treatment,revascularization,surgical operations and more.For geriatric ACS patients complicated with impaired renal function ,however,we have to carefully choose the treatment options .On one hand,renal failure caused by chronic kidney diseases （CKD） is an independent risk factor for ACS,which significantly increases the morbidity and mortality of ACS .On the other hand,impaired renal function has greatly re-stricted the application of medical treatment and the usage of coronary angiography .We can maximize patient ＇s benefit by learning about relat-ed guidelines and taking effective prophylactic measures .This article generally describes the background and status quo of CKD renal failure and ACS complicated with CKD ,listed drug recommendations from the guidelines ,and discussed considerations and prophylactic measures of revascularization treatments to provide reference for clinical settings .