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目的 分析慢性肾功能衰竭合并急性心肌梗死的临床特征 ,探讨临床指标对其预后的影响。方法 对31例慢性肾功能衰竭合并急性心肌梗死患者临床及实验室指标进行回顾性分析。结果 比较病情恶化及死亡组与病情改善组血脂 ,发现胆固醇 (TC)、甘油三酯 (TG)及载脂蛋白A(apoA)越高 ,其生存率越低 ;心肌酶谱中LDH ,CK ,CKMB ,LD1等均有不同程度地升高 ,47%的患者CK -MB阳性 ,12例肌钙蛋白测试 ,结果都呈阳性 ;冠脉造影前血Scr(2 81 6±12 8 8) μmol/L ,冠脉造影后血Scr(366 8± 164 3) μmol/L ;31例慢性肾功能衰竭合并急性心肌梗死 7例死亡 ,其中血液透析组死亡 2例 ,非透析组死亡 5例 ,2例病情恶化出院。结论 TG及TC高低与病死率有关 ,TC及TG增加死亡风险。心肌酶的高低对判断预后有重要价值 ,但肌钙蛋白T阳性需要正确分析。PTCA时非离子型造影剂对肾功能有负面影响 ,近期会导致肾功能进一步减退。慢性肾功能不全合并急性心肌梗死预后不良 ,病死率较高
Objective To analyze the clinical features of chronic renal failure combined with acute myocardial infarction (AMI) and to explore the influence of clinical indexes on its prognosis. Methods The clinical and laboratory parameters of 31 patients with chronic renal failure and acute myocardial infarction were retrospectively analyzed. Results Serum lipids were significantly higher in the death group and the disease-modifying group than in the control group. The higher the cholesterol, triglyceride and apoA were, the lower the survival rate was. The LDH, CK, CKMB, LD1 and so were all increased to some extent, 47% were positive for CK-MB and 12 were positive for troponin. The pre-angiographic blood Scr (2 81 6 ± 128 8 μmol / (366 8 ± 164 3) μmol / L after coronary angiography; 7 died of chronic renal failure combined with acute myocardial infarction, including 2 deaths in hemodialysis group, 5 deaths in non-dialysis group and 2 deaths in non-dialysis group The condition deteriorated and discharged. Conclusions The levels of TG and TC are related to the case fatality rate. TC and TG increase the risk of death. The level of myocardial enzymes have important value in judging the prognosis, but troponin T positive needs correct analysis. Non-ionic contrast agents on PTCA have a negative effect on renal function, which in the near future can lead to a further decline in renal function. Chronic renal insufficiency with acute myocardial infarction has poor prognosis and high mortality