Gensini积分与肾功能水平的关系

发布时间：2019-06-25 07:53

【摘要】：目的:探讨老年冠心病患者的临床特点及冠状动脉(冠脉)病变程度与肾功能水平的相关性。方法:按时间顺序纳入2015-05-01-2016-04-30因"胸痛"行冠脉造影检查的老年患者为研究对象,入组冠心病患者357例,其中AMI组93例、UA组164例、SA组100例,另取50例同期冠脉造影阴性者为对照组。详细记录其临床特征及相关生化指标,运用Gensini积分方法计算冠脉病变程度。结果:AMI组logGS高于UA及SA组(1.74±0.28、1.48±0.42、1.34±0.51,P0.001),且伴有偏高的血肌酐水平(95.3±31.1、83.6±22.8、86.4±22.2、76.1±15.9,P0.001)。单因素分析提示logGS与低肾小球滤过率、糖耐量异常、吸烟均有关(P0.01),多因素分析亦证实logGS与低肾小球滤过率相关性具有统计学意义(P0.01),Logistic分析提示Gensini积分与老年冠心病患者的急性冠脉综合征发生率显著相关(OR=1.007,95%CI:1.001-1.013,P=0.023)。结论:65岁以上冠心病患者中,心肌梗死患者冠脉狭窄程度最重,且伴有轻度肾功能的损害。logGS与肾功能下降有关,且Gensini积分每增加1分,急性冠脉综合征发生率也随之增加1.007倍。
[Abstract]:Objective: to investigate the clinical characteristics of elderly patients with coronary heart disease (CAD) and the correlation between the degree of coronary artery disease and renal function. Methods: according to the chronological order, the elderly patients who underwent coronary angiography due to chest pain were included in the study. There were 93 patients in AMI group, 16 patients in UA group, 100 patients in SA group, and 50 patients with negative coronary angiography in the same period as control group. The clinical features and related biochemical indexes were recorded in detail, and the degree of coronary artery disease was calculated by Gensini integral method. Results: the logGS of AMI group was higher than that of UA and SA group (1.74 卤0.28,1.48 卤0.42, 1.34 卤0.51, P0.001), and the serum creatinine level was 95.3 卤31.1, 83.6 卤22.8, 86.4 卤22.2, 76.1 卤15.9, P0.001). Univariate analysis showed that logGS was associated with low renal filtration rate, abnormal glucose tolerance and smoking (P 0.01). Multivariate analysis also confirmed that there was significant correlation between logGS and low renal filtration rate (P 0.01), Logistic analysis showed that Gensini score was significantly correlated with the incidence of acute coronary syndrome in elderly patients with coronary heart disease (OR=1.007,95%CI:1.001-1.013,P=0.023). Conclusion: among the patients over 65 years old with coronary heart disease, the degree of coronary artery stenosis is the most serious in patients with myocardial infarction, accompanied by mild renal function damage. LogGS is related to the decrease of renal function, and the incidence of acute coronary syndrome increases 1.007 times with the increase of Gensini score.
【作者单位】：广西壮族自治区人民医院心血管内科
【基金】：广西医药卫生自筹经费计划课题项目(No:Z2015310) 广西科学研究与技术开发计划项目(No:桂攻科14124003-9)
【分类号】：R541.4;R692

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