| [Background and Objective]Coronary Heart Disease (CHD) is a kind of serious disease with high death rate. In recent years, as adjustment of the way of life and the deterioration of the aging population trends, especially with the higher incidence of diabetes, high blood pressure, obesity and hyperlipemia, the incidence rate of cardiovascular Disease rise up year by year. It has become a important diseases that threat to human health. Therefore, how to reveal and intervent the risk factors of Coronary Heart Disease, prevent its occurrence and development, and improvement outcomes in patients with CHD have become a hotspot in research of cardiovascular problems.Epidemic material confirmed that patients with kidney disease, especially end-stage renal disease (ESRD) were existed cardiovascular complications in different degrees. The rates was more than50%, it was an important risk factor that indused death of patients with ESRD. A large number of clinical multicenter study also shew that renal injury is one of independent risk factors of cardiovascular disease and related to the prognosis. Chronic kidney disease (CKD) is a worldwide public health problem with an increasing incidence and prevalence in recent years. The prevalence of CKD in the general population ranged from11%to16%in western countries. According to the survey of four communitis in zhengzhou city at2007, the prevalence of CKD in the general population is about11.51%. But survey of chronic kidney disease in special crowd relatively late, preliminary research indicates that the incidence of renal injury from20to30%in patients with coronary artery disease, not only including chronic kidney disease, but also including acute acute kidney injury (AKI) came form heart failure, malignant hypertension and coronary artery. Especially the prevalence of contrast induced nephropathy (CIN) rised fastly with the gradually promotion of coronary angiography and percutaneous coronary intervention (PCI).Contrast nephropathy (CIN) refers to a kind of acute kidney injury which occurred within48h after coronary angiography and percutaneous coronary intervention (PCI). It is a common reason for renal damage. Foreign research shows that the incidence of CIN about11%, high-risk patients (the original kidney disease, diabetes, cardiac dysfunction, AMI, high blood pressure, reduced blood volume, low blood pressure, excessive use of contrast, renal toxicity and advanced age, etc) is as high as30%～40%, it have become the third largest factors to hospital-acquired kidney failure after the reduced kidney perfusion and renal toxicity drug. With the developing of the technology of radiological diagnosis and treatment and the wide application of contrast, the renal injury occurred frequently although the contrast agents steady improve. It influences the prognosis of patients with hige cardiovascular accident risk.We initiated this study among gerontalpatient with coronary heart disease, with the intention to determine the prevalence and spectrum of kidney injury in this population. It will be helpful to improve the awareness, treatment rate and control rate in the gerontalpatient with coronary heart disease, and to explore the influences of kidney damage for the CHD prognosis thouhg the analysis methods of follow-up, so as to improve the prognosis of gerontalpatient with coronary heart disease by reasonable intervention and treatment.[Methods]we retrospectively analyzed the matas of gerontalpatient diagnosed coronary heart disease.the research and collect questionnaire was designed reference for the literature at home and abroad study, including the clinical, examination, related diagnosis and prognosis material. To reveals the prevalence of renal injury patients with coronary artery disease and the related risk factors of CIN through the statistical analysis. The influence of kidney damage on the outcomes of coronary heart disease was also studied to make early prevention for CHD and improve the prognosis of gerontalpatient with coronary heart disease. Data entry and management were performed on Epidata3.0. All analyses and calculations were performed by SPSS statistical package, version13.0.[Results]1.1202subjects were accepted to investigate, and Eligible data of1116subjects were enrolled in the study. Age ranges from60to87years old and the sex ratio is1.71:1(male:female). All the subjects were suffered from CHD.331of them were complicated with hypertension and208of them were complicated with diabetes mellitus.2. The prevalence of albuminuria and reduced eGFR were18.10%and3.85%, men had higher prevalence of reduced eGFR than women (4.83%VS2.18%, χ2=4.908P=0.027)), but no Statistically significant differences in albuminuria and hematuria (19.74%VS15.29%, x2=3.477P=0.062). Both prevalence of albuminuria and reduced eGFR are increased with age(P<0.001).3.215patients were detected with chronic kidney disease. The prevalence of CKD was19.27%. Men had higher prevalence of CKD than women(21.30%VS15.78%,χ2=5.110P=0.024), it also increased with age(χ2=18.309P<0.001).4.43cases came to CIN diagnosis criteria In427patients who were gave PCI. The incidence of CIN was10.07%. And therate were15.70%and27.27%respectively in diabetes and kidney patient. Age, smoking, hypertension, hyperlipidemia, diabetes mellitus and kidney disease were independently associated with CIN from Logistic regression analysis.5. CKD patients exist coronary degrees in different degree, there have relevant relations between coronary artery disease severity and kidney damage. And CKD patients were found with higer incidence of restenosis compared to that without CKD (5.88%VS2.31%, x2=3.918P=0.048).[Conclusions]1. The elderly patients with coronary heart increase the risk of renal injury.2. The incidence of contrast induced nephropathy was common occurrences in the early patients. Age, smoking, hypertension, hyperlipidemia, diabetes mellitus and kidney disease were independently associated with CIN. 3. Kidney damage not only relates with coronary artery disease, but also influence the prognosis of the elderly patients with coronary heart. |
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