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CT 冠状动脉成像研究中冠状动脉钙化积分对肾小球滤过率下降的作用。

Role of coronary artery calcification score on the decrease in GFR among subjects with CT coronary angiography.

机构信息

Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.

出版信息

Clin Exp Hypertens. 2012;34(1):24-30. doi: 10.3109/10641963.2011.628725. Epub 2011 Dec 9.

Abstract

OBJECTIVE

Higher levels of coronary artery calcification score (CACS) are associated not only with an increased risk for cardiovascular death, but also with lower glomerular filtration rates (GFRs). However, its role in renal disease progression in patients has not been elucidated.

MATERIALS AND METHODS

We evaluated the change of estimated GFR in 279 nondialytic outpatients, who had undergone computed tomographic coronary angiography and follow-up over a period of 3 months.

RESULTS

The mean age of the participants was 57.7 ± 10.5 years, and the mean GFR was 88.2 ± 15.7 mL/min/1.73 m(2). Although there was no difference in baseline GFR between the CACS ≤ 200 AU group (n = 240) and the CACS > 200 AU group (n = 39), the latter group had a lower level of final GFR and higher annual reduction rate of GFR than the former group after an observation period of 13.1 ± 5.97 months. After adjusting for confounding variables, including age, gender, baseline GFR, albumin, and proteinuria, high levels of CACS showed an independent association with an annual reduction rate of GFR (r = -0.142, P = .048).

CONCLUSIONS

The results suggest that CACS was related to an annual decrease in GFR and may predict the faster decline in GFR in patients with symptoms requiring computed tomographic coronary angiography.

摘要

目的

冠状动脉钙化评分(CACS)水平升高不仅与心血管死亡风险增加相关,还与肾小球滤过率(GFR)降低相关。然而,其在需要进行计算机断层冠状动脉造影检查的患者的肾脏疾病进展中的作用尚未阐明。

材料和方法

我们评估了 279 名未进行透析的门诊患者的估算肾小球滤过率(eGFR)变化,这些患者在 3 个月的时间内进行了计算机断层冠状动脉造影检查和随访。

结果

参与者的平均年龄为 57.7 ± 10.5 岁,平均 eGFR 为 88.2 ± 15.7 mL/min/1.73 m2。尽管 CACS≤200 AU 组(n=240)和 CACS>200 AU 组(n=39)的基线 eGFR 没有差异,但后者组的最终 eGFR 水平较低,且在观察期 13.1 ± 5.97 个月后,其 eGFR 年下降率更高。在校正了年龄、性别、基线 eGFR、白蛋白和蛋白尿等混杂变量后,高水平的 CACS 与 eGFR 年下降率呈独立相关(r=-0.142,P=0.048)。

结论

结果表明 CACS 与 eGFR 的年度下降有关,可能预示着需要进行计算机断层冠状动脉造影检查的患者的 GFR 下降更快。

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