术前高尿酸血症对冠状动脉旁路移植术后急性肾损伤发生的影响  

Impact of Preoperative Hyperuricemia on Acute Kidney Injury After Coronary Artery Bypass Grafting

作　　者：侯杰[1] 樊国亮[2,3] 王正清 刘志刚[2] HOU Jie;FAN Guoliang;WANG Zhengqing;LIU Zhigang(Department of Pharmacy,Teda International Cardiovascular Hospital,Tianjin 300457,China)

机构地区：[1]泰达国际心血管病医院药剂科,天津市300457 [2]泰达国际心血管病医院心脏外科,天津市300457 [3]上海东方医院

出　　处：《中国循环杂志》2021年第12期1186-1190,共5页Chinese Circulation Journal

摘　　要：目的:探讨行冠状动脉旁路移植术(CABG)患者术前高尿酸血症对术后急性肾损伤(AKI)发生的影响。方法:回顾性分析1446例择期单纯行CABG的成年患者,并根据术后是否发生AKI分为AKI组与非AKI组,通过单因素分析及二分类多元Logistic回归分析评价围术期各因素与术后AKI发生的关系。结果:1446例患者中132例(9.13%)术后发生AKI,279例(19.29%)合并高尿酸血症。AKI组高尿酸血症比例明显高于非AKI组(13.26%vs.8.14%,P=0.008)。校正年龄、性别、体重指数、伴发疾病、心肾功能、体外循环、桥血管数目等因素后,二分类多元Logistic回归分析显示,术前高尿酸血症是CABG后发生AKI的独立危险因素(OR=1.483,95%CI:0.936~2.320),其他危险因素还包括使用血液制品>2000 ml(OR=2.474,95%CI:1.601~3.686)、呼吸机时间>36 h(OR=5.187,95%CI:3.303~8.147)、辅助器械应用(OR=4.184,95%CI:2.309~7.581),P均<0.05。结论:术前高尿酸血症是CABG后AKI发生的独立危险因素,CABG前对高危人群采取早期、积极的预防性措施,或有助于改善预后。Objectives:To investigate the impact of preoperative hyperuricemia on acute kidney injury(AKI)after coronary artery bypass grafting(CABG).Methods:Clinical data of 1446 adult patients undergoing CABG were retrospectively analyzed.They were divided into AKI group and non AKI group according to whether AKI occurred after CABG.The relationship between perioperative factors and postoperative AKI was evaluated by univariate analysis and binary multiple logistic regression analysis.Results:Among the 1446 patients,there were 132 patients(9.13%)developed AKI and 279(19.29%)complicated with hyperuricemia.The proportion of hyperuricemia in AKI group was significantly higher than that in non AKI group(13.26%vs.8.14%,P=0.008).After adjusting for age,sex,body mass index,concomitant diseases,cardiorenal function,cardiopulmonary bypass and the number of bridging vessels,binary multiple logistic regression analysis showed that preoperative hyperuricemia was an independent risk factor for AKI after CABG(OR=1.483,95%CI:0.936-2.320),other risk factors included blood products>2000 ml(OR=2.474,95%CI:1.601-3.686),ventilator time>36 h(OR=5.187,95%CI:3.303-8.147),application of auxiliary devices(OR=4.184,95%CI:2.309-7.581),all P<0.05.Conclusions:Preoperative hyperuricemia is an independent risk factor for AKI after CABG.Preoperative preventive measures for high-risk population should be taken earlier and more actively in order to reduce the AKI post CABG and improve the prognosis of patients undergoing CABG.

关 键 词：冠状动脉旁路移植术 高尿酸血症 急性肾损伤 危险因素 

分 类 号：R54[医药卫生—心血管疾病]