摘要:目的:了解血肌酐清除率受损是否与冠心病患病率存在联系。方法:纳入2006年7月至2008年2月期间经冠状动脉造影证实的冠心病患者及年龄、性别匹配的对照组,按血肌酐清除率值将患者分为正常［≥90 mg/（mL·173 m2)］,轻度受损［≥60 mg/（mL·1.73 m2）,lt;90 mg/（mL·1.73 m2)］和明显受损［lt;60 mg/（mL·1.73 m2)］。比较冠心病组与对照组各组人群的比例有无差异。结果:研究期间共纳入冠心病组和对照组患者各116例。在冠心病组中,血肌酐清除率正常患者82例、轻度受损29例、重度受损5例,对照组中,正常患者98例、轻度受损13例、重度受损5例,〖JP3〗两组比较分布有统计学差异(χ2值7.517,P=0.023)。与对照组比较,冠心病组的血清肌酐值无明显差异（Pgt;005)，〖JP〗冠心病组（103.29±51.08） μmol/L,对照组（102.67±41.21）μmol/L。结论:血肌酐清除率降低是冠心病的危险因素。Abstract: Objective: To disclose the relation of the estimated glomerular filtration rate (eGFR) and coronary artery disease. Methods：We analyzed eGFR in the patients with coronary artery disease confirmed by coronary angiography and the control, and compared the proportion of patients with reduced renal function in the different groups. Results: A total 116 cases were included in each group. Among these patients, normal renal function, mildly and severe reduced renal function was documented in 82, 29 and 5 in coronary artery disease group, and in 98, 13 and 5 in the control group, respectively. In comparison to the control, more patients with reduced eGFR were found in coronary artery disease group (χ2 value 7.517,P=0.023), although no significant difference was observed between both groups（Pgt;0.05). Conclusion: Reduced eGFR, even if mildly, could be regarded as the risk factor of coronary artery disease.
ObjectiveTo explore the association between preoperative, perioperative parameters, especially estimated glomerular filtration rate (eGFR) and postoperative atrial fibrillation (POAF) after modified extended Morrow procedure.MethodsA total of 300 hypertrophic obstructive cardiomyopathy (HOCM) patients who underwent modified extended Morrow procedure in our hospital from January 2012 to March 2018 were collected. There were 197 (65.67%) males and 103 (34.33%) females with an average age of 43.54±13.81 years. Heart rhythm was continuously monitored during hospitalization. The patients were divided into a POAF group (n=68) and a non-POAF group (n=232). The general data, perioperative parameters and echocardiographic results were collected by consulting medical records for statistical analysis. Univariate and multivariate logistic regression models were used to analyze the risk factors for POAF.ResultsOverall incidence of POAF during hospitalization was 22.67% (68/300). Compared with patients without POAF, patients with POAF were older, had higher incidence of chest pain and syncope, lower level of preoperative eGFR, higher body mass index and heart function classification (NYHA), larger preoperative left atrial diameter and left ventricular end diastolic diameter, and longer ventilator-assisted time, ICU stay and postoperative hospital stay. Age, heart function classification (NYHA)≥Ⅲ, hypertension, syncope history and eGFR were independent risk factors for POAF. Receiver operating characteristic curve analysis showed that the area under the curve of eGFR was 0.731 (95%CI 0.677-0.780, P<0.001), and the sensitivity and specificity were 82.4% and 57.8%, respectively.ConclusionIncreased age, high preoperative heart function classification (NYHA), hypertension, preoperative syncope history and decreased eGFR are independent risk factors for POAF in HOCM patients who underwent surgical septal myectomy. Preoperative decreased eGFR can moderately predict the occurrence of POAF after modified extended Morrow procedure.