AMI患者PCI术后发生急性肾损伤的危险因素及对预后的影响  

Risk factors of acute kidney injury and prognosis in patients with acute myocardial infarction after PCI

作　　者：刘玉玺[1] 刘伟利[1] 黄玉 Liu Yuxi;Liu Weili;Huang Yu(Cardiac Center,People's Hospital of Henan Province,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院心脏中心、郑州大学华中阜外医院心脏康复科,郑州450003

出　　处：《中国循证心血管医学杂志》2023年第4期453-455,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210086)。

摘　　要：目的 探讨急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后发生急性肾损伤的相关危险因素及对预后的影响。方法 选择我院于2020年1月至2022年6月收治的90例AMI患者作为研究对象,患者均行PCI,记录术后急性肾损伤的发生率,分析AMI患者PCI术后发生急性肾损伤的危险因素,并观察PCI术后半年不良心血管事件的发生情况。结果 90例患者中,PCI术后发生急性肾损伤11例,发生率为12.22%;单因素分析显示,不同年龄、Killip心功能分级、左室射血分数(LVEF)、造影剂剂量、术前肾功能不全、基线肌酐清除率(CCR),患者PCI术后急性肾损伤的发生率比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄、Killip心功能分级、LVEF、造影剂剂量、术前肾功能不全、基线CCR均是AMI患者PCI术后发生急性肾损伤的危险因素(P<0.05);PCI术后随访半年,均无死亡患者,发生急性肾损伤的患者不良心血管事件总发生率为45.45%,明显高于未发生急性肾损伤患者的7.59%,差异有统计学意义(P<0.05)。结论 AMI患者PCI术后发生急性肾损伤的原因涉及到较多因素,且对短期预后具有不良影响,应给予高度关注。Objective To discuss the risk factors related to acute kidney injury(AKI)and prognosis in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods AMI patients(n=90)undergone PCI were chosen from People's Hospital of Henan Province from Jan.2020 to June 2022.The incidence of AKI was recorded,and risk factors of AKI were analyzed in AMI patients after PCI.The occurrence of major adverse cardiovascular events(MACE)was observed in patients after PCI for 6 months.Results In 90 patients,AKI occurred in 11 patients(12.22%).The results of single-factor analysis showed that the differences in age,Killip grades,left ventricular ejection fraction(LVEF),contrast agent dosage,preoperative renal insufficiency,baseline creatinine clearance rate(CCR)and AKI incidence after PCI had statistical significance(P<0.05).The results of multi-factor Logistic regression analysis showed that age,Killip grades,LVEF,contrast agent dosage,preoperative renal insufficiency and baseline CCR were risk factors of AKI in AMI patients after PCI(P<0.05).The results of follow-up after PCI for 6 months,there were no died patients.The total incidence of MACE was 45.45%in AKI patients and 7.59%in non-AKI patients(P<0.05).Conclusions The causes of AKI involve many factors in AMI patients after PCI,and these factors have adverse effects on their short-term prognosis,which should be given high attention.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 急性肾损伤 危险因素 预后 

分 类 号：R542.22[医药卫生—心血管疾病]