老年冠心病患者PCI术后AKI发生情况及对住院期间不良心血管事件的影响  

Occurrence of acute kidney injury and its influence on in-hospital adverse cardiovascular events in elderly patients with coronary heart disease after PCI

作　　者：张艺 关丹妮 王赛 Zhang Yi;Guan Danni;Wang Sai(Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital),Qingdao 266000,China;不详)

机构地区：[1]康复大学青岛医院(青岛市市立医院),青岛266000 [2]青岛海慈医疗集团南院,青岛266000

出　　处：《中国循证心血管医学杂志》2023年第1期99-101,105,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨老年冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入治疗(PCI)术后急性肾损伤(AKI)发生情况及对住院期间不良心血管事件的影响。方法回顾性分析2020年1月至2022年7月于青岛市市立医院接受PCI的150例老年冠心病患者的临床资料,根据术后AKI发生情况分为AKI组(n=18)和非AKI组(n=132),比较两组患者的一般情况及住院期间不良心血管事件发生率,采用多因素Logistic回归分析患者PCI术后发生AKI的危险因素。结果AKI组年龄、糖尿病、术前肾功能不全、术前左室射血分数(LVEF)≤45%、术前Killip分级<2级、术中造影剂用量≥200 ml的患者及基线肾小球滤过率(eGFR)、尿酸(UA)水平均高于非AKI组,差异有统计学意义(P<0.05);AKI组住院期间不良心血管事件发生率明显高于非AKI组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、糖尿病、术前肾功能不全、术前LVEF≤45%、术前Killip分级<2级、术中造影剂用量≥200 ml、基线eGFR、UA均是老年冠心病患者PCI术后发生AKI的危险因素(P<0.05)。结论老年冠心病患者术后AKI发生率较高,病因众多,可增加住院期间不良心血管事件发生率,临床应予以关注。Objective To investigate the occurrence of acute kidney injury(AKI)and its influence on in-hospital adverse cardiovascular events in elderly patients with coronary heart disease(CHD)after PCI.Methods The elderly CHD patients(n=150)received PCI were retrospectively analyzed in Qingdao Municipal Hospital from Jan.2020 to July 2022.All patients were divided,according to AKI occurrence,into AKI group(n=18)and non-AKI group(n=132).The general conditions and incidence rates of adverse cardiovascular events were compared between 2 group.The risk factors of AKI were analyzed by using multi-factor Logistic regression analysis in patients after PCI.Results In AKI group,age,and the percentages of patients with diabetes,preoperative renal insufficiency,preoperative LVEF≤45%,preoperative Killip grade<2,intraoperative contrast agent dosage≥200 mL,and levels of estimated glomerular filtration rate(eGFR)and uric acid(UA)were all higher than those in non-AKI group(P<0.05).The incidence rates of adverse cardiovascular events were significantly higher in AKI group than those in non-AKI group during hospitalization(P<0.05).The results off multi-factor Logistic regression analysis showed that age,diabetes,preoperative renal insufficiency,preoperative LVEF≤45%,preoperative Killip grade<2,intraoperative contrast agent dosage≥200 mL,eGFR and UA all were risk factors of AKI in elderly CHD patients after PCI(P<0.05).Conclusion The incidence rate of AKI is higher with more pathological causes,and adverse cardiovascular events will be increased in in elderly CHD patients after PCI,which should be paid close attention to in clinical practice.

关 键 词：冠心病 老年 经皮冠状动脉介入治疗 急性肾损伤 不良心血管事件 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]