糖尿病患者行冠状动脉旁路移植术后发生急性肾损伤的危险因素分析  

Risk factors for acute kidney injury after coronary artery bypass grafting in diabetic patients

作　　者：刘韬帅[1] 李扬[1] 候雪见 许士俊 董然[1] LIU Taoshuai;LI Yang;HOU Xuejian;XU Shijun;DONG Ran(Department of Cardiac Surgeryn,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心脏外科11病房,100029

出　　处：《心肺血管病杂志》2022年第7期784-787,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(81570373)。

摘　　要：目的:本研究对糖尿病患者行冠状动脉旁路移植(CABG)术后急性肾损伤(AKI)的危险因素进行回顾性分析,以便及早发现相关危险因素并采取积极的干预措施。方法:2018年至2019年,共纳入433例择期行CABG术的糖尿病患者,根据肾脏疾病改善全球结局(KDIGO)标准定义AKI。将患者分为发生AKI组(AKI组)和未发生AKI组(非AKI组)。多因素Logistic回归分析筛选出的影响因素。结果:433例患者中,111例患者(25.6%)发生了AKI。BMI(OR=0.545,95%CI:0.332~0.896,P=0.017),吸烟(OR=1.839,95%CI:1.131~2.991,P=0.014)、呼吸机使用时间延长(OR=1.023,95%CI:1.014~1.033,P<0.001)和尿素氮(OR=1.297,95%CI:1.144~1.470,P<0.001)是发生AKI的危险因素。ROC曲线下面积为0.745(95%CI:0.691~0.800,P<0.001)。结论:BMI、吸烟、呼吸机使用时间延长、尿素氮是糖尿病患者行CABG术发生AKI的危险因素。早期发现这些危险因素并实施相应的干预措施,有助于减少CABG术后AKI的发生,改善患者预后。Objective:This study is to investigate acute kidney injury(AKI)after coronary artery bypass grafting(CABG)in diabetic patients.The risk factors of AKI were retrospectively analyzed in order to identify relevant risk factors and take positive intervention measures.Methods:from 2018 to 2019,433 patients with diabetes undergoing elective CABG were enrolled,and AKI was defined according to the standard of global improvement of renal disease(KDIGO).Patients were divided into AKI group(AKI group)and AKI group without occurrence.Results:Among 433 patients,111 patients(25.6%)had AKI,BMI(OR=0.545,95%CI:0.332-0.896,P=0.017),smoking(OR=1.839,95%CI:1.131-2.991,P=0.014),prolonged use of ventilator(OR=1.023,95%CI:1.014-1.033,P<0.001)and urea nitrogen(OR=1.297,95%CI:1.144-1.470,P<0.001)was an independent risk factor for AKI.The area under the ROC curve was 0.745(95%CI:0.691-0.800,P<0.001).Conclusions:BMI,smoking,prolonged use of ventilator and urea nitrogen are independent risk factors for AKI in patients with diabetes mellitus undergoing CABG.Early detection of these risk factors and implementation of corresponding intervention measures will help to reduce the incidence of AKI after CABG and improve the prognosis of patients.

关 键 词：急性肾损伤 冠状动脉旁路移植术 糖尿病 

分 类 号：R54[医药卫生—心血管疾病]