慢性肾脏病患者经皮冠脉介入术后急性肾损伤预后及影响因素分析  

Analysis of clinical prognosis and affecting factors for CKD patients with acute kidney injury after percutaneous coronary intervention

作　　者：贾丽芳[1] 周培一[1] 白文英[1] Jia Lifang;Zhou Peiyi;Bai Wenying(Department of Nephrology, Beijing Daxing District People′s Hospital, Beijing 102600, China)

机构地区：[1]北京市大兴区人民医院肾内科,102600

出　　处：《中华肾病研究电子杂志》2021年第3期133-137,共5页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

摘　　要：目的了解慢性肾脏病(CKD)患者经皮冠脉介入术(PCI)后发生急性肾损伤(AKI)的临床预后及其影响因素。方法回顾2016年1月至2020年8月北京市大兴区人民医院CKD患者PCI术后发生AKI患者的临床资料,对其预后情况及影响因素进行分析;使用Logistic回归方法分析影响肾功能恢复的危险因素。结果共纳入PCI术后发生AKI的CKD患者119例,好转出院102例(85.71%),死亡/放弃治疗出院17例(13.79%)。肾功能恢复51例(42.86%),未恢复68例(57.14%)。恢复组与未恢复组在术前血肌酐、尿蛋白、术前eGFR分期、AKI分期、Killip分级等指标方面存在统计学差异(P<0.05)。多因素Logistic回归分析显示尿蛋白阳性、术前CKD分期>3b期、AKI分期≥2期、Killip分级≥Ⅱ级是影响PCI术后AKI恢复的独立危险因素。结论PCI术后发生AKI的CKD患者肾脏预后差,肾功能恢复受多种因素影响。Objective To investigate the clinical prognosis and affecting factors for acute kidney injury(AKI)after percutaneous coronary intervention(PCI)in patients with chronic kidney disease(CKD).Methods A retrospective study was made on the clinical data of CKD patients with AKI after PCI from January 2016 to August 2020 in Beijing Daxing District People′s Hospital.The clinical prognosis and affecting factors were analyzed.The logistic regression method was used to analyze the risk factors in the renal function recovery.Results A total of 119 patients were enrolled,of whom 102(85.71%)were discharged after improvement from hospital,and 17(13.79%)died or had treatment abandonment.Among the 119 patients,51 cases(42.86%)recovered from AKI while 68 cases(57.14%)failed.There were statistically significant differences between the recovered group and the unrecovered group in preoperative serum creatinine,urine protein,preoperative eGFR stage,AKI stage,and Killip classification(P<0.05).Multivariate logistic regression analysis showed that the independent risk factors for the recovery of the renal function included positive urine protein,preoperative CKD stage>3b,AKI stage≥2,and Killip classification≥Ⅱ.Conclusion The renal prognosis of AKI after PCI in patients with CKD was poor,and the recovery of the renal function could be affected by many factors.

关 键 词：慢性肾脏病 经皮冠脉介入术 急性肾损伤 预后 

分 类 号：R69[医药卫生—泌尿科学]