作者：王彩蕊，马彩云，任凤学

单位：

航空总医院心内科

Units：

Department of Cardiology, Aviation General Hospital, Beijing 100012, China

关键词：

冠心病; 尿微量白蛋白与尿肌酐比值; 冠状动脉狭窄;

Keywords：

Coronary disease; U-mAlb/Ucr; Coronary artery stenosis

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.100

Funds：

摘要：

目的 探讨尿微量白蛋白与尿肌酐比值（U-mAlb/Ucr）与冠心病（CHD）患者冠状动脉狭窄程度的关系。方法 回顾性选取2021年8月至2022年8月在航空总医院心内科住院的CHD患者228例为研究对象。收集患者临床资料，包括年龄、性别、吸烟史、高血压史、糖尿病史、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（HbA1c）、U-mAlb/Ucr。依据冠状动脉造影检查结果，将患者分为轻中度狭窄组（所有冠状动脉狭窄程度<75%,n=102）和重度狭窄组（至少有1支冠状动脉的狭窄程度≥75%,n=126）。采用多因素Logistic回归分析探讨CHD患者冠状动脉狭窄程度的影响因素。结果 重度狭窄组年龄大于轻中度狭窄组，有吸烟史、糖尿病史者占比及HbA1c、U-mAlb/Ucr高于轻中度狭窄组（P<0.05）。多因素Logistic回归分析结果显示，年龄[OR=1.034,95%CI(1.003,1.065)]、吸烟史[OR=2.093,95%CI(1.043,4.201)]、糖尿病史[OR=2.528,95%CI(1.257,5.084)]、HbA1c[OR=1.358,95%CI(1.038,1.777)]、U-mAlb/Ucr[OR=1.058,95%CI(1.031,1.085)]是CHD患者冠状动脉狭窄程度的影响因素（P<0.05）。结论 U-mAlb/Ucr升高是CHD患者冠状动脉重度狭窄的危险因素。

Abstract：

Objective To explore the relationship between the ratio of microalbumin and creatinine of the random urine (U-mAlb/Ucr) and the degree of coronary artery stenosis in patients with coronary heart disease (CHD) . Methods A total of 228 patients with CHD who were hospitalized in the Department of Cardiology of Aviation General Hospital from August 2021 to August 2022 were retrospectively selected as the study objects. The clinical data of patients were collected, including age, sex, smoking history, hypertension history, diabetes history, low density lipoprotein cholesterol (LDL-C) , glycosylated hemoglobin (HbA1c) , U-mAlb/Ucr. According to the results of coronary angiography, patients were divided into mild-moderate stenosis group (all coronary artery stenosis < 75%, n=102) and severe stenosis group (at least 1 coronary artery stenosis ≥75%, n=126) . Multivariate Logistic regression analysis was used to investigate the influencing factors of the degree of coronary artery stenosis in patients with CHD. Results The age of severe stenosis group was older than that of mild-moderate stenosis group, and the proportion of patients with smoking history and diabetes history, HbA1c and U-mAlb/Ucr were higher than those of mild-moderate stenosis group (P < 0.05) . Multivariate Logistic regression analysis showed that age [OR=1.034, 95%CI (1.003, 1.065) ] , smoking history [OR=2.093, 95%CI (1.043, 4.201) ] , diabetes history [OR=2.528, 95%CI (1.257, 5.084) ] , HbA1c [OR=1.358, 95%CI (1.038, 1.777) ] , U-mAlb/Ucr [OR=1.058, 95%CI (1.031, 1.085) ] were the influencing factors of coronary artery stenosis in patients with CHD (P < 0.05) . Conclusion Elevated U-mAlb/Ucr is a risk factor for severe coronary artery stenosis in patients with CHD.

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