CAJ | 학술논문

目的调查疑似冠心病行冠脉造影患者的慢性肾脏病(CKD)流行情况.方法 2008年12月至2009年10月,于东南大学附属中大医院心内科住院行选择性冠脉造影的1031例患者为对象,观察其CKD的患病率及其危险因素.CKD的定义为Egfr<60 ml·min-1.(1.73 m2)-1和(或)蛋白尿,Egfr以简化MDRD公式计算.冠心病定义为至少1支冠脉狭窄≥50%.结果　患者平均年龄(64.37±11.02)岁,其中男性543例,女性488例;冠心病551例.CKD 134例(13%),冠心病组CKD的患病率显著高于非冠心病组(18.33%比6.88%,P<0.01).随冠脉病变支数增加(0、1、2、3支),Egfr逐渐下降[(84.24±19.00)、(81.61±23.92)、(75.16±20.99)、(73.92±20.66)ml·min-1·(1.73 m2)-1,P<0.01];蛋白尿患者比例逐渐增加(0.42%、0.82%、1.96%、3.25%,P=0.006);CKD患病率逐渐增高(6.88%、13.11%、21.57%、23.38%,P<0.01).Logistic回归提示年龄增长(OR=1.094,95%CI 1.068～1.120)、冠脉病变支数增加(OR=1.288,95%CI 1.074～1.543)、高血压(OR=1.974,95%CI 1.082～3.603)、心脏收缩功能不全(OR=3.183,95%C/1.696-5.972)、高尿酸血症(OR=5.366,95%C/3.224～8.931)是CKD的重要危险因素.结果　冠脉造影证实的冠心病患者中,CKD患病率显著高于非冠心病者,且随冠脉病变支数增加而显著增加.年龄增长、冠脉病变支数增加、高血压、心脏收缩功能不全、高尿酸血症为CKD的危险因素.
목적 조사의사관심병행관맥조영환자적만성신장병(CKD)류행정황.방법 2008년12월지2009년10월,우동남대학부속중대의원심내과주원행선택성관맥조영적1031례환자위대상,관찰기CKD적환병솔급기위험인소.CKD적정의위Egfr<60 ml·min-1.(1.73 m2)-1화(혹)단백뇨,Egfr이간화MDRD공식계산.관심병정의위지소1지관맥협착≥50%.결과　환자평균년령(64.37±11.02)세,기중남성543례,녀성488례;관심병551례.CKD 134례(13%),관심병조CKD적환병솔현저고우비관심병조(18.33%비6.88%,P<0.01).수관맥병변지수증가(0、1、2、3지),Egfr축점하강[(84.24±19.00)、(81.61±23.92)、(75.16±20.99)、(73.92±20.66)ml·min-1·(1.73 m2)-1,P<0.01];단백뇨환자비례축점증가(0.42%、0.82%、1.96%、3.25%,P=0.006);CKD환병솔축점증고(6.88%、13.11%、21.57%、23.38%,P<0.01).Logistic회귀제시년령증장(OR=1.094,95%CI 1.068～1.120)、관맥병변지수증가(OR=1.288,95%CI 1.074～1.543)、고혈압(OR=1.974,95%CI 1.082～3.603)、심장수축공능불전(OR=3.183,95%C/1.696-5.972)、고뇨산혈증(OR=5.366,95%C/3.224～8.931)시CKD적중요위험인소.결과　관맥조영증실적관심병환자중,CKD환병솔현저고우비관심병자,차수관맥병변지수증가이현저증가.년령증장、관맥병변지수증가、고혈압、심장수축공능불전、고뇨산혈증위CKD적위험인소.
Objective To investigate the prevalence of CKD in patients underging coronary angiography with suspected coronary heart disease(CHD). Methods A total of 1031patients with suspected CHD undergoing coronary angiography in Zhongda Hospital from December 2008 to October 2009 were enrolled in the study.The prevalence of CKD and associated risk factors were analyzed.GFR Wag estimated with MDRD equation.CKD was deftned as eGFR<60branches of coronary artery was considered as CHD. Results The mean age of patients were (64.37±11.02)years.There were 543 males and 488 females,including 551 patients with CHD and 134 patients with CKD(13%).Patients with CHD had a significantly higher prevalence of CKD compared with patients without CHD(18.33%vs 6.88%,P<0.01).With the increasing number of stenosis coronary vessels(n=0,1,2,3),eGFR was declined[(84.25±19.00),(81.61±23.92),increased(0.42%,0.82%,1.96%,3.25%,P=0.006),and the prevalence of CKD increased (6.88%,13.11%,21.57%,23.38%,P<0.01).Logistic regression analysis indicated that increasing age(OR 1.094,95%C/1.068 to 1.120),increasing number of stenosis coronary vessels(OR 1.288,95%CI 1.074 to 1.543).hypertension(OR 1.974,95%CI 1.082 to 3.603),cardiac systolic insufficiency(OR 3.183,95%CI 1.696 to 5.972),and hyperuricemia(OR 5.366,95%CI 3.224 to 8.9311 were risk factors for CKD. Conclusions The prevalence of CKD in patients with CHD diagnosed by coronary angiography is quite high.Aging,elevated number of stenosis coronary vessels,hypertension,cardiac systolic insufficiency and hyperuricemia are important risk factors for angiographic patients with CKD.