冠心病患者合并肾动脉狭窄的危险因素分析

发布时间：2018-04-29 09:26

本文选题：肾动脉狭窄 + 动脉粥样硬化　；参考：《解放军医学杂志》2017年12期

【摘要】：目的探讨冠心病患者中动脉粥样硬化性肾动脉狭窄(ARAS)的相关危险因素。方法纳入2016年5月-2016年9月因疑诊和确诊冠心病连续就诊于沈阳军区总医院行选择性冠状动脉造影术及非选择性肾动脉造影术的患者677例,分析肾动脉狭窄的发生率,根据肾动脉狭窄程度将患者分为肾动脉正常组(肾动脉造影正常)、肾动脉轻度狭窄组(肾动脉狭窄50%)和肾动脉明显狭窄组(肾动脉狭窄≥50%),采用单因素及多因素logistic回归分析冠心病合并ARAS的危险因素。结果 677例患者中,肾动脉明显狭窄发生率为18.9%(128/677),肾动脉轻度狭窄发生率为16.7%(113/677)。肾动脉狭窄患者的年龄、收缩压、脉压、肌酐均高于肾动脉正常组(P0.05),女性、高血压、左主干病变比例与肾动脉正常组相比差异均有统计学意义(P0.05);肾动脉轻度狭窄组冠脉双支病变比例高于肾动脉正常组(P0.05)。肾动脉明显狭窄组年龄、脉压、肌酐水平明显高于其他两组(P0.05),且外周血管病变、左主干病变、冠脉单支及三支病变比例明显高于其他两组(P0.05)。单因素及多因素logistic回归分析结果显示,年龄、女性、外周血管病变、冠脉多支病变是ARAS的独立危险因素。结论高龄、女性、伴有外周血管病变的冠心病患者易发生肾动脉狭窄,在冠状动脉造影的同时应行肾动脉造影,以尽早发现ARAS,并进行肾动脉评估。
[Abstract]:Objective to investigate the risk factors associated with atherosclerotic renal artery stenosis (ARAS) in patients with coronary heart disease (CAD). Methods 677 patients who underwent selective coronary angiography and non selective renal arteriography in the Shenyang military district general hospital in September, May 2016, in September, were enrolled in the diagnosis and diagnosis of coronary heart disease, and the renal artery stenosis was analyzed. The incidence of renal artery stenosis was divided into normal renal artery group (normal renal arteriography), mild renal stenosis group (renal artery stenosis 50%) and renal artery stenosis group (renal artery stenosis more than 50%). The risk factors of coronary heart disease combined with ARAS were analyzed by single factor and multiple factor Logistic regression. Results of 677 patients, renal artery stenosis, renal artery stenosis and renal artery stenosis. The incidence of obvious arterial stenosis was 18.9% (128/677), and the incidence of mild renal artery stenosis was 16.7% (113/677). The age, systolic pressure, pulse pressure and creatinine of renal artery stenosis were higher than those of normal renal artery (P0.05), women, hypertension, and the proportion of left main artery disease were statistically significant (P0.05) compared with that of the normal renal artery (P0.05); mild renal artery was mild. The proportion of coronary double branch lesions in the stenosis group was higher than that of the normal renal artery group (P0.05). The age, pulse pressure and creatinine level in the renal artery stenosis group were significantly higher than those of the other two groups (P0.05), and the proportion of peripheral vascular lesions, left main stem lesions, coronary artery single branch and three branch lesions was significantly higher than that of the other two groups (P0.05). Single factor and multiple factor Logistic regression analysis results were found. It is shown that age, women, peripheral vascular lesions and multiple coronary artery lesions are independent risk factors for ARAS. Conclusions elderly, female, and peripheral vascular lesions are prone to renal artery stenosis and renal arteriography should be performed at the same time as coronary angiography in order to present ARAS as early as possible and to evaluate the renal artery.

【作者单位】：沈阳军区总医院心内科;
【基金】：国家临床重点专科军队建设项目(2017)~~
【分类号】：R541.4;R692

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