摘要
目的评价心脏手术患者术前心功能对术后并发急性肾损伤(AKI)的影响。方法回顾性分析2004年1月1日—2007年6月30日在上海交通大学医学院附属仁济医院行心脏手术的所有住院患者的资料,采用AKI网络(AKIN)推荐的AKI定义统计心脏手术后AKI的发生率,对患者术前的心功能进行评估,并分析其他可能造成术后AKI的危险因素。结果1056例患者中,术后发生AKI328例,发生率为31.1%。AKI组的院内病死率为11.6%(38/328),显著高于非AKI组的0.7%(5/728,P<0.01)。多因素Logistic回归分析显示,在校正年龄、术前高尿酸血症、冠状动脉旁路移植联合瓣膜手术、手术时间、术后循环血容量不足等因素后,术前左心功能不全仍是心脏手术后发生AKI的独立危险因素(OR=2.53,95%CI为1.24～5.13,P=0.01)。结论术前左心功能不全是心脏手术后发生AKI的独立危险因素。
Objective To assess the influence of the pre-operative cardiac function on the incidence of acute kidney injury （AKI） following cardiac surgeries. Methods We retrospectively analyzed the patients who underwent open heart surgery in Renji Hospital, Shanghai Jiaotong University School of Medicine from Jan. 1st 2004 to Jun. 30th 2007. Univariate and multivariate analyses were used to evaluate possible pre-, intra-, and postoperation parameters associated with AKI using AKI Network （AKIN）. Results Of the 1056 patients, 328 （31.1% ） had AKI after operation. The hospital mortality of AKI patients was significantly higher than that of non- AKI patients （11. 6% vs. 0.7%, P〈0.01）. Multivariate logistic regression analysis showed that, after adjustment for age, pre-operation hyperuricemia, CABG combined surgery, operation time, post-operative circulation volume insufficiency, pre-operative left ventricular insufficiency were still independent risk factors for AKI （OR=2.53,95% CI：1.24--5.13, P=0.01）.Conclusion Pre-operative left ventricular insufficiency is an ndependent risk factor of AKI.
出处
《上海医学》
CAS
CSCD
北大核心
2009年第8期685-689,共5页
Shanghai Medical Journal
基金
上海市医学发展基金重点研究课题资助项目(2003ZD001)
关键词
急性肾损伤
心脏手术
术前心功能
危险因素
Acute kidney injury
Cardiac surgery
Pre-operative cardiac function
Risk factors
