外科术后氟比洛芬酯相关急性肾损伤的影响因素研究  

Study on the influencing factors of Flurbiprofen Axetil related acute kidney injury after surgery

作　　者：袁湘敏 肖坚[2] 黄丽 YUAN Xiangmin;XIAO Jian;HUANG Li(Department of Pharmacy,Zhuzhou Central Hospital,Hunan Province,Zhuzhou412000,China;Department of Pharmacy,Xiangya Hospital of Central South University,Hunan Province,Changsha410000,China)

机构地区：[1]湖南省株洲市中心医院药学部,湖南株洲412000 [2]中南大学湘雅医院药学部,湖南长沙410000

出　　处：《中国医药导报》2023年第15期131-134,158,共5页China Medical Herald

基　　金：湖南省自然科学基金面上项目(2021JJ31043);湖南省自然科学基金科药联合基金项目(2021JJ80089);湖南省株洲市科技指导性计划项目(株科发〔2019〕57号)。

摘　　要：目的分析外科术后氟比洛芬酯(FA)相关急性肾损伤(AKI)的影响因素。方法回顾性调查2019年1至12月于湖南省株洲市中心医院使用FA的所有手术住院患者,采集患者临床资料,FA使用时机、给药剂量、疗程,收集基线及用药后7 d内的肌酐值等。采用单因素和多因素logistic回归分析,筛选AKI的危险因素。结果859例外科术后应用FA镇痛的患者中,94例发生AKI。不同年龄、重度贫血、低蛋白血症、慢性肾脏病、肝硬化及合并使用利尿剂、血管紧张素Ⅱ受体阻断药(ARB)、血管紧张素转化酶抑制剂(ACEI)患者的AKI发生率比较,差异有统计学意义(P<0.05)。多因素分析结果显示,重度贫血(OR=23.094,95%CI:4.604~115.853)、慢性肾脏病(OR=12.080,95%CI:5.505~26.509)、肝硬化(OR=4.113,95%CI:1.602~10.558)、ARB(OR=6.076,95%CI:2.553~14.462)、ACEI(OR=5.985,95%CI:3.060~11.703)是患者AKI发生的独立危险因素(P<0.05),年龄19~45岁(OR=0.359,95%CI:0.172~0.753)、>45~65岁(OR=0.330,95%CI:0.181~0.604)是患者AKI发生的独立保护因素(P<0.05)。结论外科术后FA相关AKI较常见。早期识别影响因素,积极采取干预措施,以预防和减少AKI的发生。Objective To analyze the influencing factors of Flurbiprofen Axetil(FA)related acute kidney injury(AKI)after surgery.Methods All surgical inpatients who used FA in Zhuzhou Central Hospital between January and December 2019 were retrospectively investigated.The clinical data,use time,dosage and treatment course of FA were collected.The creatinine value of baseline and within seven days after treatment and others were collected.Univariate and multivariate analyses were performed with logistic regression model to assess the risk factors of AKI.Results Among 859 patients who received postoperative FA analgesia,94 patients developed AKI.The incidence rate of AKI in patients with different ages,severe anemia,hypoproteinemia,chronic kidney disease,liver cirrhosis,and combined use of diuretics,angiotensinⅡreceptor blockers(ARB),and angiotensin-converting enzyme inhibitor(ACEI)were compared,with statistical differences(P<0.05).The results of multi factor analysis showed that severe anemia(OR=23.094,95%CI:4.604 to 115.853),chronic kidney disease(OR=12.080,95%CI:5.505 to 26.509),liver cirrhosis(OR=4.113,95%CI:1.602 to 10.558),ARB(OR=6.076,95%CI:2.553 to 14.462),and ACEI(OR=5.985,95%CI:3.060 to 11.703)were independent risk factors for the occurrence of AKI in patients(P<0.05).Age 19 to 45 years old(OR=0.359,95%CI:0.172 to 0.753)and>45 to 65 years old(OR=0.330,95%CI:0.181 to 0.604)were independent protective factors for AKI(P<0.05).Conclusion FA related AKI is common after surgery.Early identification of risk factors and proactive interventions to prevent and reduce the occurrence of AKI.

关 键 词：氟比洛芬酯 急性肾损伤 药源性肾损害 影响因素 

分 类 号：R692.9[医药卫生—泌尿科学]