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目的探讨中老年冠心病患者动脉粥样硬化性肾动脉狭窄的患病率和危险因素。方法对339例冠脉造影诊断为冠心病的中老年患者,同时进行选择性双侧肾动脉造影。结果肾动脉狭窄的发生率为37.2%(126/339)。肾动脉狭窄组年龄、高血压病、吸烟者的比率均高于非肾动脉狭窄组(P<0.001、<0.03、<0.02),肾动脉狭窄患病率随病变程度加重有逐渐增加的趋势(2趋势=4.17,P<0.0001)。多因素回归分析中,年龄、高血压、吸烟和冠心病多支病变为肾动脉狭窄的独立危险因素(P<0.05)。结论中老年冠心病患者,尤其是高龄、高血压、吸烟、多支病变的患者应常规行选择性肾动脉造影。
Objective To investigate the prevalence and risk factors of atherosclerotic renal artery stenosis in middle-aged and elderly patients with coronary heart disease. Methods 339 middle-aged and elderly patients diagnosed as coronary heart disease by coronary angiography were undergone selective bilateral renal artery angiography at the same time. Results The incidence of renal artery stenosis was 37.2% (126/339). The prevalence of renal artery stenosis was higher in patients with renal artery stenosis than in non-renal artery stenosis group (P <0.001, <0.03, <0.02). The prevalence of renal artery stenosis increased with the severity 2 trend = 4.17, P <0.0001). Multivariate regression analysis showed that age, hypertension, smoking and coronary artery disease were independent risk factors of renal artery stenosis (P <0.05). Conclusion Patients with coronary heart disease in middle-aged and elderly patients, especially elderly, high blood pressure, smoking, multi-vessel disease should be routinely performed selective renal artery angiography.