Serov V A, Shutov A M, Khiteeva S V, Makeeva E R, Serova S I, Troshen'kina O V
Klin Med (Mosk). 2009;87(12):36-9.
To evaluate clinical features of chronic cardiac insufficiency (CCI) in elderly patients with renal dysfunction.
260 patents (143 men and 117 women) aged above 60 (mean 68.7 +/- 6.6) yr with I-IV FC CCI. 25 patients had hypertensive disease (HD), 30 coronary heart disease (CHD), 205 HD+CHD. Glomerular filtration rate (GFR) was estimated using MDRD formula.
Chronic renal disease (CRD) with GFR reduced below 60 ml/min/1.73 m2 was diagnosed in 126 (48.5%) patients. Its severity was not significantly different between patients with and without CCI. (2.3 +/- 0.7 and 2.1 +/- 0.7 respectively, p = 0.13). The entire study group was dominated by men, the CCI group by women. Atrial fibrillation (AF) was diagnosed in 25.8% of the patients with CI + CRD. Multivariate regression analysis revealed independent correlation of AF with CCI FC (p = 0.02) and GFR (p = 0.2). CCI patients with CRD had higher frequency of mitral regurgitation (MR) than without CRD. Occurrence of MR correlated with age (p < 0.001) and GFR (p < 0.001).
评估老年肾功能不全患者慢性心功能不全（CCI）的临床特征。
260例年龄在60岁以上（平均68.7±6.6岁）的I-IV级FC CCI患者（143例男性和117例女性）。25例患有高血压病（HD），30例患有冠心病（CHD），205例患有HD+CHD。采用MDRD公式估算肾小球滤过率（GFR）。
126例（48.5%）患者被诊断为GFR低于60 ml/min/1.73 m2的慢性肾病（CRD）。其严重程度在有和无CCI的患者之间无显著差异（分别为2.3±0.7和2.1±0.7，p = 0.13）。整个研究组以男性为主，CCI组以女性为主。25.8%的CI + CRD患者被诊断为房颤（AF）。多因素回归分析显示AF与CCI FC（p = 0.02）和GFR（p = 0.2）独立相关。患有CRD的CCI患者二尖瓣反流（MR）的发生率高于无CRD的患者。MR的发生与年龄（p < 0.001）和GFR（p < 0.001）相关。
