TAVR术后患者发生明显急性肾损伤危险因素评估  

Evaluation on the Risk Factors of Obvious Acute Renal Injury in Patients after TAVR

作　　者：周锦玲 丘汉彬 张萍珍[1] ZHOU Jinling;QIU Hanbin;ZHANG Pingzhen(不详;Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《中外医学研究》2022年第22期160-164,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:评估经导管主动脉瓣置换术(TAVR)后患者明显急性肾损伤(AKI)的发病率及危险因素。方法:选取北京大学深圳医院2020年1月-2021年5月接受TAVR的80例患者参与本次研究,通过患者接受TAVR术后是否发生明显AKI分为AKI组(n=18)和非AKI组(n=62),通过单因素分析比较两组之间一般临床特征指标(包括人口统计学数据、共病、超声心电图数据和血清实验室值等)、手术细节、并发症等相关指标的差异,并采用回归分析AKI的危险因素。结果:所有研究对象在接受TAVR术后7 d内,80例中有18例患者出现明显AKI,发病率为22.5%;单因素分析可知非AKI组出现慢性阻塞性肺疾病、主要及次要血管并发症的发生率较AKI组明显更低,且手术时间更短,红细胞输注率更低,而跨瓣压较AKI组更高(P<0.05)。回归分析显示,主要及次要血管并发症、手术时间、慢性阻塞性肺疾病及红细胞输注是患者接受TAVR后出现明显AKI事件的独立危险因素(P<0.05)。结论:主要及次要血管并发症、手术时间、慢性阻塞性肺疾病及红细胞输注是严重主动脉瓣狭窄患者接受TAVR后出现明显AKI事件的独立危险因素。Objective:To evaluate the incidence rate and risk factors of obvious acute kidney injury(AKI)in patients after transcatheter aortic valve replacement(TAVR).Method:A total of 80 patients who received TAVR in Peking University Shenzhen Hospital from January 2020 to May 2021 were participate in the research.The patients were separated into AKI group(n=18)and non AKI group(n=62)according to whether they occured obvious AKI after TAVR.The differences in general clinical characteristics(including demographic data,comorbidity,ultrasonic ECG data and serum laboratory values),surgical details,complications and related indicators between the two groups were compared through univariate analysis,the risk factors of AKI were analyzed by regression.Result:Within 7 days after TAVR,18 of the 80 patients had serious AKI,with a incidence rate of 22.5%.Univariate analysis showed that the incidence of chronic obstructive pulmonary disease,major and minor vascular complications in the non AKI group were significantly lower than those in the AKI group,and the operation time was shorter,the incidence of red blood cell transfusion was lower,while the cross valve pressure was higher than that in AKI group(P<0.05).Regression analysis showed that major and minor vascular complications,operation time,chronic obstructive pulmonary disease and red blood cell transfusion were independent risk factors for obvious AKI after TAVR(P<0.05).Conclusion:Major and minor vascular complications,operation time,chronic obstructive pulmonary disease and red blood cell transfusion are independent risk factors for obvious AKI after TAVR in patients with severe aortic stenosispatients.

关 键 词：经导管主动脉瓣置换术 急性肾损伤 发病率 

分 类 号：R654.2[医药卫生—外科学] R692[医药卫生—临床医学]