摘要
目的探讨ST段抬高型急性冠状动脉综合征(ST-segment elevation acute coronary syndrome,STE-ACS)患者肾功能特点及影响因素。方法急性冠状动脉综合征(acute coronary syndrome,ACS)患者488例,按是否发生STE-ACS分为STE-ACS组68例和非STE-ACS组420例。分析患者临床特征、肾功能情况,采用多因素logistic回归分析影响ACS患者发生STE-ACS的因素。结果 STE-ACS组患者高血压病史比率、糖尿病病史比率、血清肌酐、三酰甘油、同型半胱氨酸、载脂蛋白B、非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol,non-HDL-C)水平以及载脂蛋白B/载脂蛋白A比值均高于非STE-ACS组,肾小球滤过率(estimated glomerular filtration rate,eGFR)[(53.59±21.92)mL/(min·1.73m2)]低于非STE-ACS组[(73.70±20.06)mL/(min·1.73m2)](P<0.05);488例中合并肾功能不全368例,发生率为75.41%,非STE-ACS组轻、中度、重度肾功能不全发生率(55.00%、16.19%、3.80%)与STE-ACS组(54.41%、17.65%、5.88%)比较差异均无统计学意义(P>0.05);多因素logistic回归分析显示,non-HDL-C(OR=1.786,95%CI:1.139~2.800,P=0.012)、eGFR(OR=0.959,95%CI:0.940~0.977,P<0.001)是ACS患者发生STE-ACS的危险因素。结论 ACS患者以并发轻度肾功能不全为主,eGFR和non-HDL-C是STE-ACS发生的主要影响因素。
Objective To explore the renal function changes and risk factors for ST-segment elevation acute coronary syndrome （STE-ACS）. Methods Totally 488 patients with acute coronary syndrome （ACS） were divided into STE-ACS group （n= 68） and non-STE-ACS group （n=420） to compare the clinical features and renal function changes. The risk factors for STE-ACS in ACS patients were analyzed by logistic regression method. Results The proportions of hypertension and diabetes, the levels of serum creatinine, triacylglycerol, homocysteine, apolipoprotein B and non-high-density lipoprotein cholesterol （non-HDL-C）, as well as the ratio of apolipoprotein B to apolipoprotein A were significantly higher in STE-ACS group than those in non-STE-ACS group （P〈0.05）. The level of estimated glomerular filtration rate （eGFR） was significantly lower in STE-ACS group （（53.59±21.92）mL/（min·1.73 m2） ） than that in non-STE-ACS group （（73.70±20.06）mL/（min·1.73m2）） （P〈0.05）. In 488 patients, 368 patients （75.41%） were complicated with renal insufficiency. There were no significant differences in the incidences of mild, moderate and severe renal insufficiency betweefi STE-ACS group （54.41%, 17.65%, 5. 88%） and non-STE-ACS group （55.00%, 16.19%, 3.80%） （P〉 0.05）. Multivariable logistic regression analysis showed that non-HDL-C （OR= 1. 786, 95% CI： 1. 139-2. 800, P=0. 012） and eGFR （OR=0. 959, 95%CI： 0. 940-0. 977, P=0. 000） were the risk factors for STE-ACS in ACS patients. Conclusion The patients with ACS are commonly complicated with mild renal insufficiency. Non-HDL-C and eGFR are the main risk factors for STE-ACS.
作者
朱佳璐
高传玉
王宪沛
晏娟娟
张优
王山
ZHU Jia-lu;GAO Chuan-yu;WANG Xian-pei;YAN Juan-juan;ZHANG You;WANG Shan(Department of Cardiology,Henan Provincial People＇s Hospital,People＇s Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华实用诊断与治疗杂志》
2018年第8期791-793,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
2016年度河南省医学科技攻关计划普通项目(201602210)
关键词
ST段抬高型急性冠状动脉综合征
肾功能不全
肾小球滤过率
非高密度脂蛋白胆固醇
ST-segment elevation acute coronary syndromes renal insufficiency
estimated glomerular filtration rate
non-high-density lipoprotein cholesterol
