老年肾功能不全患者冠脉病变特点的相关研究进展
Research Progress on the Characteristics of Coronary Artery Lesions in Elderly Patients with Renal Insufficiency
DOI: 10.12677/ACM.2023.13112574, PDF,   
作者: 阿孜古丽·古拉木江, 罗 梅*:新疆医科大学第五临床医学院心血管内科,新疆 乌鲁木齐
关键词: 冠心病慢性肾脏病动脉粥样硬化血管钙化Coronary Heart Disease Chronic Kidney Disease Atherosclerosis Vascular Calcification
摘要: 慢性肾脏病(CKD)是冠状动脉疾病(CAD)发生发展的重要危险因素,具有较高的死亡率。CKD患者冠脉病变严重而复杂,除了糖尿病和高血压等传统冠心病危险因素外,CKD患者还暴露出其他与尿毒症相关的非传统心血管疾病危险因素。老年人因身体机能减退,多合并潜在肾功能不全,患者的肾小球滤过率明显下降,会导致其病情复杂,而目前大部分研究为非老年患者,因此,本文旨在通过对老年CKD中冠脉病变特点的分析,对老年慢性肾功能不全患者冠脉粥样硬化特点做如下综述。
Abstract: Chronic kidney disease (CKD) is an important risk factor for the occurrence and development of coronary artery disease (CAD) with high mortality. Coronary artery disease in patients with CKD is serious and complex. In addition to traditional coronary heart disease risk factors such as diabetes and hypertension, CKD patients are also exposed to other non-traditional cardiovascular disease risk factors related to uremia. The glomerular filtration rate of elderly patients is significantly de-creased due to physical dysfunction and potential renal insufficiency, which will lead to a complex condition. At present, most of the studies are non-elderly patients. Therefore, this paper aims to summarize the characteristics of coronary atherosclerosis in elderly patients with chronic renal in-sufficiency through the analysis of the characteristics of coronary artery lesions in elderly patients with CKD.
文章引用:阿孜古丽·古拉木江, 罗梅. 老年肾功能不全患者冠脉病变特点的相关研究进展[J]. 临床医学进展, 2023, 13(11): 18335-18341. https://doi.org/10.12677/ACM.2023.13112574

参考文献

[1] Dusing, P., Zietzer, A., Goody, P.R., et al. (2021) Vascular Pathologies in Chronic Kidney Disease: Pathophysiological Mechanisms and Novel Therapeutic Approaches. Journal of Molecular Medicine, 99, 335-348. [Google Scholar] [CrossRef] [PubMed]
[2] Roth, G.A., Mensah, G.A., Johnson, C.O., et al. (2020) Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update from the GBD 2019 Study. Journal of the American College of Cardiology, 76, 2982-3021.
[3] 《中国心血管健康与疾病报告》编写组. 《中国心血管健康与疾病报告2021》概述[J]. 中国心血管病研究, 2022, 20(7): 577-596.
[4] Valdivielso, J.M., Rodriguez-Puyol, D., Pascual, J., et al. (2019) Atherosclerosis in Chronic Kidney Disease: More, Less, or Just Different? Arteriosclerosis, Thrombosis, and Vascular Biology, 39, 1938-1966. [Google Scholar] [CrossRef
[5] Loftus, T.J., Filiberto, A.C., Ozrazgat-Baslanti, T., et al. (2021) Cardiovascular and Renal Disease in Chronic Critical Illness. Journal of Clinical Medicine, 10, Article 1601. [Google Scholar] [CrossRef] [PubMed]
[6] Lopau, K. and Wanner, C. (2021) Treatment Rationale for Coronary Heart Disease in Advanced CKD. Herz, 46, 221-227. [Google Scholar] [CrossRef] [PubMed]
[7] Zhang, X., Hu, L. and Zheng, W. (2018) Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft in Acute Coro-nary Syndrome Patients with Renal Dysfunction. Scientific Reports, 8, Article No. 2283. [Google Scholar] [CrossRef] [PubMed]
[8] Liao, G.Z., Li, Y.M., Bai, L., Ye, Y.Y. and Peng, Y. (2021) Re-vascularization vs. Conservative Medical Treatment in Patients with Chronic Kidney Disease and Coronary Artery Dis-ease: A Meta-Analysis. Frontiers in Cardiovascular Medicine, 8, Article 818958. [Google Scholar] [CrossRef] [PubMed]
[9] Raggi, P. (2017) Cardiovascular Disease: Coronary Artery Calcifi-cation Predicts Risk of CVD in Patients with CKD. Nature Reviews Nephrology, 13, 324-326. [Google Scholar] [CrossRef] [PubMed]
[10] Sakaguchi, Y., Hamano, T., Obi, Y., et al. (2019) A Randomized Trial of Magnesium Oxide and Oral Carbon Adsorbent for Coronary Artery Calcification in Predialysis CKD. Journal of the American Society of Nephrology, 30, 1073-1085. [Google Scholar] [CrossRef
[11] Nelson, A.J., Raggi, P., Wolf, M., et al. (2020) Targeting Vascular Calcification in Chronic Kidney Disease. JACC: Basic to Translational Science, 5, 398-412. [Google Scholar] [CrossRef] [PubMed]
[12] Mori, H., Torii, S., Kutyna, M., et al. (2018) Coronary Artery Calcification and Its Progression: What Does It Really Mean? JACC: Cardiovascular Imaging, 11, 127-142. [Google Scholar] [CrossRef] [PubMed]
[13] Sarnak, M.J., Amann, K., Bangalore, S., et al. (2019) Chronic Kidney Disease and Coronary Artery Disease: JACC State-of-the-Art Review. Journal of the American College of Car-diology, 74, 1823-1838.
[14] 杨爽, 刘锋, 李淼, 等. 慢性肾脏病患者微炎症致动脉粥样硬化的机制研究进展[J]. 中国实验诊断学, 2020, 24(3): 530-532.
[15] Zanoli, L., Lentini, P., Briet, M., et al. (2019) Arterial Stiffness in the Heart Disease of CKD. Journal of the American Society of Nephrology, 30, 918-928. [Google Scholar] [CrossRef
[16] Baaten, C., Vondenhoff, S. and Noels, H. (2023) Endothelial Cell Dysfunction and Increased Cardiovascular Risk in Patients with Chronic Kidney Disease. Circulation Research, 132, 970-992. [Google Scholar] [CrossRef
[17] Li, H., Li, M., Liu, C., et al. (2023) Causal Effects of Systemic Inflammatory Regulators on Chronic Kidney Diseases and Renal Function: A Bidirectional Mendelian Ran-domization Study. Frontiers in Immunology, 14, Article 1229636. [Google Scholar] [CrossRef] [PubMed]
[18] Dai, Z. and Zhang, X. (2023) Pathophysiology and Clinical Im-pacts of Chronic Kidney Disease on Coronary Artery Calcification. Journal of Cardiovascular Development and Disease, 10, Article 207. [Google Scholar] [CrossRef] [PubMed]
[19] Roumeliotis, S., Mallamaci, F. and Zoccali, C. (2020) Endothelial Dys-function in Chronic Kidney Disease, from Biology to Clinical Outcomes: A 2020 Update. Journal of Clinical Medicine, 9, Article 2359. [Google Scholar] [CrossRef] [PubMed]
[20] Laville, S.M., Couturier, A., Lambert, O., et al. (2022) Urea Levels and Cardiovascular Disease in Patients with Chronic Kidney Disease. Nephrology Dialysis Transplantation, 38, 184-192.
[21] Six, I., Flissi, N., Lenglet, G., et al. (2020) Uremic Toxins and Vascular Dysfunction. Toxins, 12, Article 404. [Google Scholar] [CrossRef] [PubMed]
[22] El Chamieh, C., Liabeuf, S. and Massy, Z. (2022) Uremic Toxins and Cardiovascular Risk in Chronic Kidney Disease: What Have We Learned Recently beyond the Past Findings? Toxins, 14, Article 280. [Google Scholar] [CrossRef] [PubMed]
[23] 李天力, 王显, 李本志, 等. 冠心病伴慢性肾功能不全病人不同中医证型的冠状动脉病变特征分析[J]. 中西医结合心脑血管病杂志, 2022, 20(24): 4425-4428.
[24] Virani, S.S., Alonso, A., Benjamin, E.J., et al. (2020) Heart Disease and Stroke Statistics-2020 Update: A Report from the American Heart Association. Circulation, 141, e139-e596.
[25] Kyriakidis, N.C., Cobo, G., Dai, L., Lindholm, B. and Stenvinkel, P. (2021) Role of Uremic Toxins in Early Vascular Ageing and Calcification. Toxins, 13, Article 26. [Google Scholar] [CrossRef] [PubMed]
[26] Wojtasińska, A., Frąk, W., Lisińska, W., et al. (2023) Novel Insights into the Molecular Mechanisms of Atherosclerosis. International Journal of Molecular Sciences, 24, Article 13434. [Google Scholar] [CrossRef] [PubMed]
[27] Castelli, R., Gidaro, A., Casu, G., et al. (2023) Aging of the Arterial System. International Journal of Molecular Sciences, 24, Article 6910. [Google Scholar] [CrossRef] [PubMed]
[28] 邓仁生, 农盛雄. 老年冠心病合并肾功能不全行冠脉心脏介入治疗的临床研究[J]. 中国现代药物应用, 2019, 13(14): 26-28.
[29] Giustino, G., Mehran, R., Serruys, P.W., et al. (2018) Left Main Revascularization with PCI or CABG in Patients with Chronic Kidney Disease: EXCEL Trial. Journal of the American College of Cardiology, 72, 754-765.
[30] Li, Y., Hou, X., Xu, X., et al. (2022) Coronary Artery Bypass Grafting vs. Percutaneous Coronary In-tervention in Coronary Artery Disease Patients with Advanced Chronic Kidney Disease: A Chinese Single-Center Study. Frontiers in Surgery, 9, Article 1042186. [Google Scholar] [CrossRef] [PubMed]
[31] Li, Y., Hou, X., Liu, T., et al. (2022) Comparison of Coronary Artery Bypass Grafting and Drug-Eluting Stent Implantation in Patients with Chronic Kidney Disease: A Propensity Score Matching Study. Frontiers in Cardiovascular Medicine, 9, Article 802181. [Google Scholar] [CrossRef] [PubMed]
[32] Gallo, M., Blitzer, D., Laforgia, P.L., et al. (2022) Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft for Left Main Coronary Artery Disease: A Meta-Analysis. The Journal of Thoracic and Cardiovascular Surgery, 163, 94-105.E115. [Google Scholar] [CrossRef] [PubMed]
[33] Song, B., Dai, D., Liu, S., et al. (2021) Optimal Timing of Coro-nary Angiograms for Patients with Chronic Kidney Disease: Association between the Duration of Kidney Dysfunction and SYNTAX Scores. Renal Failure, 43, 307-312. [Google Scholar] [CrossRef
[34] Spertus, J.A., Jones, P.G., Maron, D.J., et al. (2020) Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease. The New England Journal of Medicine, 382, 1619-1628. [Google Scholar] [CrossRef
[35] Bangalore, S., Maron, D.J. and Hochman, J.S. (2020) Management of Coronary Disease in Patients with Advanced Kidney Disease. The New England Journal of Medicine, 383, 1091-1092. [Google Scholar] [CrossRef
[36] Tasoudis, P.T., Varvoglis, D.N., Tzoumas, A., et al. (2022) Percuta-neous Coronary Intervention versus Coronary Artery Bypass Graft Surgery in Dialysis-Dependent Patients: A Pooled Meta-Analysis of Reconstructed Time-to-Event Data. Journal of Cardiac Surgery, 37, 3365-3373. [Google Scholar] [CrossRef] [PubMed]
[37] 涂少文. 冠心病合并肾功能不全患者PCI术后回顾性分析[D]: [硕士学位论文]. 汕头: 汕头大学, 2022.
[38] Golub Ilana, S., Termeie Orly, G., Kristo, S., et al. (2023) Major Global Coronary Artery Calcium Guidelines. JACC: Cardiovascular Imaging, 16, 98-117. [Google Scholar] [CrossRef] [PubMed]
[39] Townsend, R.R. (2019) Arterial Stiffness in CKD: A Review. American Journal of Kidney Diseases, 73, 240-247. [Google Scholar] [CrossRef] [PubMed]
[40] 陈珂, 聂振禹, 包蓓艳. 慢性肾脏病患者动脉粥样硬化相关生物标志物研究进展[J]. 浙江医学, 2020, 42(23): 2591-2593, 2598.