关键词: 血红蛋白, 估算的肾小球滤过率, 经皮冠状动脉扩张术, 预后

Abstract: Objective　To evaluate the prognostic value of combining estimated glomerular filtration rate（eGFR）and hemoglobin（Hb）in chronic kidney disaese（CKD）patients with coronary artery disease after percutaneous coronary artery intervention（PCI）in hospital and 4 years after hospitalization. Methods　According to the eGFR and Hb levels，1 005 PCI patients with coronary artery disease were classified into 4 groups:18 cases in eGFR＜60 mL/min and anemia group，52 cases in eGFR＜60 mL/min and normal Hb group，37 cases in eGFR≥60 mL/min and anemia group and 898 cases in eGFR≥60 mL/min and normal Hb group.The levels of serum creatinine and Hb of PCI patients were measured，and the basic situations of sex，age，smoking，body mass index（BMI），hyperlipaemia，hypertension，diabetes mellitus，the presence or absence of prior myocardial infarction and perioperative PCI were compared among the 4 groups. All patients were followed up from 30 d to 4 years，and the median was 3 years.The survival analysis based on COX proportional hazard models.Kaplan-Meier survival analysis was used for comparing survival curves among the 4 groups.The Log-rank statistic was used for comparing survival rate among the groups. Results　Sex，BMI and perioperative PCI had no statistical significance among the 4 groups（P＞0.05）. Smoking，hyperlipaemia，diabetes mellitus，the presence or absence of prior myocardial infarction，counts of narrow coronary artery，age，hypertension and left ventricular ejection fraction（LVEF）were detected with statistical significance among the 4 groups（P＜0.05）. The days after PCI had statistical significance（H＝18.399，P＝0.000）. Through multivariate COX regression correcting BMI，smoking，hypertension，hyperlipaemia，diabetes mellitus，the presence or absence of prior myocardial infarction，counts of narrow coronary artery and perioperative PCI，the relative risk（RR）of the increasing counts of narrow coronary artery with cardiac events was 1.333[95％confidence interval（CI）: 1.023-1.738，P＝0.033]. The RR of perioperative PCI was 3.142（95％CI: 1.974-5.001，P＝0.000）.The RR of Hb was 1.006（95％CI: 0.990-1.023，P＝0.446）.The survival rates in the first，second，third and fourth year were different.The each year survival rates of eGFR＜60 mL/min and anemia group were 94.4%，88.9%，83.3% and 83.3%，of eGFR＜60 mL/min and normal Hb group were 98.1%，94.2%，88.5% and 86.5%，of eGFR≥60mL/min and anemia group were 97.3%，94.6%，91.9% and 91.9%，and of eGFR≥60 mL/min and normal Hb group were 99.7%，97.2%，93.7% and 91.6%.The survival rates had statistical significance among the 4 groups（H＝10.440，P＝0.015），and the survival rate of group with eGFR＜60 mL/min and anemia was significantly lower than those of the other 3 groups. Conclusions　It has a value to use combining eGFR and Hb to evaluate the prognosis of CKD patients with coronary artery disease after PCI who have a high morbidity of major adverse cardiac events.

Key words: Hemoglobin, Estimated glomerular filtration rate, Percutaneous coronary artery intervention, Prognosis