冠状动脉旁路移植术后急性肾损伤的影响因素分析  

Analysis of influential factors of acute renal injury after coronary artery bypass grafting

作　　者：张国安[1] 黄晓燕[1] 冯大伟 石践[1] 李学文[1] 邵展社[1] ZHANG Guo-an;HUANG Xiao-yan;FENG Da-wei;SHI Jian;LI Xue-wen;SHAO Zhan-she(Department of Cardiovascular Surgery y Shanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院心血管外科,陕西省西安市710068

出　　处：《中国心血管病研究》2019年第11期979-982,共4页Chinese Journal of Cardiovascular Research

基　　金：陕西省重点研发计划项目(2017SF-127);陕西省人民医院科技发展孵化基金资助项目(2015YX-3)。

摘　　要：目的探讨冠状动脉旁路移植(coronary artery bypass grafting,CABG)术后急性肾损伤(acute kidney injury,AKI)的发生率以及相关影响因素.方法选择连续行择期CABG的123例患者为研究对象,根据改善全球肾脏病后果(Kidney Disease:Improving Global Outcome,KDIGO)组织指南中的AKI诊断标准,统计AKI在术后的发生率.以是否发生AKI把患者分为AKI组和对照组,对比分析两组间临床资料的差异.将差异有统计学意义的因素作为自变量进行回归分析,寻找AKI的相关影响因素.结果术后有48例(39.02%)患者发生AKI,结果显示术前高血压、舒张功能减低、视黄醇结合蛋白、尿蛋白、桥血管数量和呼吸机使用时间在两组间比较有统计学意义.单因素回归分析显示,术前高血压、舒张功能减低、视黄醇结合蛋白、术中桥血管数量以及术后呼吸机使用时间是CABG后AKI的危险因素.多因素回归分析显示,术前高血压、视黄醇结合蛋白及术后呼吸机使用时间是CABG后AKI的独立危险因素.结论CABG术后AKI有较高的发生率(39.02%),高血压、视黄醇结合蛋白及呼吸机使用时间是CABG后AKI的独立危险因素.Objective To investigate the incidence,relate factors and effect on the acute kidney injury(AKI)after coronary bypass grafting(CABG).Methords 123 consecutive patients who underwent scheduled CABG were enrolled.AKI was diagnosed according to the diagnostic criteria from KDIGO(Kidney Disease:Improving Global Outcome).The patients were divided into AKI group and control group without AKI.Difference of clinic features was contrasted between the two groups.Univariate and Multivariate regression analysis were used to identify the risk factors of AKI.Results AKJ occurred in 39.02%patients(48/123).There was significant difference between the two groups in hypertension,reduced left ventricular diastolic function,retinol binding protein,urinary protein,number of grafts,the duration of mechanic ventilation.Hypertension,reduced left ventricular diastolic function,retinol binding protein,number of grafts and the duration of mechanic ventilation were risk factors of AKI in Univariate regression analysis.Hypertension,retinol binding protein and the duration of mechanic ventilation were risk factors of AKI in multivariate regression analysis.Conclusion The incidence of AKI was high(39.02%).Hypertension,retinol binding protein and the duration of mechanic ventilation were independent risk factors of AKI after CABG.

关 键 词：冠状动脉旁路移植术 急性肾损伤 危险因素 体外循环 

分 类 号：R654.2[医药卫生—外科学]