CAJ | 학술논문

目的了解老年冠心病( CHD)合并慢性肾脏病( CKD)三期患者的动脉粥样硬化相关指标的特点。方法年龄≥65岁的住院患者239例，分为CHD合并CKD3组68例，单纯CHD组100例，同期住院的无CHD及CKD的老年患者为对照组71例。记录一般情况，测定糖化血红蛋白、血清肌酐、尿素氮、尿酸、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白，计算血浆致动脉粥样硬化指数( AIP)。行颈动脉内膜中层厚度检测(IMT)、踝臂指数(ABI)测定、心脏超声检查及24小时动态血压检测计算24小时脉压(24PP)。结果 CHD+CKD三期组AIP、IMT高于CHD组及对照组，与对照组比较，差异有显著性。 CHD+CKD三期组ABI低于CHD组及对照组，差异均有显著性。 CHD+CKD三期组PP高于CHD组及对照组，差异有显著性。结论 AIP、IMT、ABI、24PP异常在老年CHD合并CKD三期患者中更明显，上述指标可能为这一人群动脉粥样硬化危险性的评估指标。
목적료해노년관심병( CHD)합병만성신장병( CKD)삼기환자적동맥죽양경화상관지표적특점。방법년령≥65세적주원환자239례，분위CHD합병CKD3조68례，단순CHD조100례，동기주원적무CHD급CKD적노년환자위대조조71례。기록일반정황，측정당화혈홍단백、혈청기항、뇨소담、뇨산、총담고순、감유삼지、고밀도지단백、저밀도지단백，계산혈장치동맥죽양경화지수( AIP)。행경동맥내막중층후도검측(IMT)、과비지수(ABI)측정、심장초성검사급24소시동태혈압검측계산24소시맥압(24PP)。결과 CHD+CKD삼기조AIP、IMT고우CHD조급대조조，여대조조비교，차이유현저성。 CHD+CKD삼기조ABI저우CHD조급대조조，차이균유현저성。 CHD+CKD삼기조PP고우CHD조급대조조，차이유현저성。결론 AIP、IMT、ABI、24PP이상재노년CHD합병CKD삼기환자중경명현，상술지표가능위저일인군동맥죽양경화위험성적평고지표。
Objective To investigate the characteristics of atherosclerosis indexes of elderly patients who were CHD complicated with CKD stage 3. Method Enrolled two hundred and thirty-nine elderly patients (≥65 years old) were divided into 3 groups:coronary heart diaease ( CHD) with chronic kidney disease( CKD) stage3 group, CHD group and the control group. General clinical data of subjects were recorded. Glycated hemoglobin A1C, Serum cre-atinine, Blood urea nitrogen, Uric acid,Total cholesterol, Triglyceride, High density lipoprotein, Low density lipo-protein were measured and calculated Atherogenic index of plasma ( AIP) . Ankle brachial index ( ABI) , carotid in-ter-media thickness ( IMT) and Ambulatory blood pressure ( ABP) parameters were measured respectively. Result AIP and IMT in the CHD with CKD stage3 group was higher than that in the control group (P<0. 05 ), ABI in the CHD +CKD3 group was lower than that in both CHD group and the control group (P<0. 05 ). Pulse Pressure(PP) in the CHD with CKD stage3 group were higher than those in the CHD group and control group (P<0. 05 ). Con-clusion AIP、IMT、ABI、PP abnormality were more obvious and may serve as risk markers to elderly CHD with CKD stage3 patients.