微量白蛋白尿与冠状动脉病变相关性探讨

摘要

Objective To investigate the relevance of microalbuminuria ( MA) to the severity of coronary lesions in patients with coronary heart disease , to investigate whether microalbuminuria ( MA) can be related to the prediction of coronary artery disease and its severity .Methods 330 consecutive patients with CHD were enrolled ,194 males and 136 females ( mean age 66 ±11 ) .All patients underwent coronary artery angiography ( CAG) .The severity of coronary artery disease ( CAD) was evaluated by Gensini scores and assessed by the numbers of vessel disease and microalbuminuria expressed by the albumin to creatinine ratio ( ACR) .The patients were divided into two groups:the CHD group and the group without CHD .The clinical features and ACR between the two groups were compared, and correlations of microalbuminuria and severity of coronary artery disease were analyzed .Results CHD patients had higher MA positive rate than non-CHD patients (29.9%vs 3.0%, P<0.01).MA positive rate increased progressively with severity of CAD and the numbers of vessel disease .The difference had statistical significance .MA was independent risk factor of CHD ( P=0.045).Conclusion Micoalbuminuira is associated with coronary heart disease (CHD); micoalbuminuira is associated with the se-verity of coronary lesions in patients with CHD and is an independent predictor of CAD .Micoalbuminuira is an independent risk factor of CHD .Micoalbuminuira can be used to screen the high risk CHD population and evaluate the severity of CHD .%目的：探讨微量白蛋白尿（ microalbuminuria，MA）与冠状动脉病变严重程度之间的相关性，以确定MA是否可作为冠心病及其严重程度的一项预测指标。方法对330例入选病例均行冠状动脉造影术，男194例，女136例，平均（66．0±11．0）岁。根据冠状动脉造影结果分为冠心病组及非冠心病组，对冠状动脉进行评分，计算冠状动脉病变支数，同时检测患者尿白蛋白／肌酐比值（urinary albumin／creatinin，ACR），对两组间临床指标、ACR等进行比较，并分析MA与冠状动脉病变的相关性。结果冠心病组MA阳性率明显高于非冠心病组（29．9％vs 3．0％，P＜0．01）。随着冠状动脉病变数量和程度的增加，MA发生率逐渐增高，差异有统计学意义（P＜0．05）。 MA为冠心病独立危险因素（P＝0．045）。结论 MA与冠心病相关， MA与冠状动脉病变数量和程度密切相关，且对冠状动脉病变程度具有一定的预测价值。 MA是冠心病的独立危险因素。检测ACR，有助于识别冠心病高危患者，并可能反映冠状动脉病变严重程度。