摘要
目的探讨心脏介入治疗术后并发急性肾损伤（AKI）的肾脏危险因素，以及术前肾损害因素与AKI发生率之间的关系。方法回顾性分析2009年1月-20012年1月间在我院行心脏介入治疗术的成人患者的临床资料。分别统计患者术前及术后48h内血清肌酐（Scr）值、术后48h内尿量，评价有无AKI的发生；采用回归分析等统计学方法研究Scr、尿素氮（BUN）、血尿、蛋白尿，肾脏影像学异常等因素与AKI之间的关系。结果选取的152例成人患者中，心脏介入治疗术后48h内并发AKI有33例（21．7％）；单因素分析发现术前蛋白尿，肾脏体积缩小或弥漫性改变．肾积水，血肌酐、尿素氮浓度增高，eGFR≤90ml·min^-1·（1．73m2）。等因素与AKI的发生明显相关（P〈0．05或0．01）；Logistic回归分析结果显示术前蛋白尿，肾脏体积缩小或弥漫性改变，血肌酐浓度增高为术后并发AKI的独立危险因素。结论蛋白尿，肾脏体积缩小或弥漫性改变．肾积水，血肌酐、尿素氮增高，eGFR≤90ml·min^-1·（1．73m2）^-1是心脏介入治疗术后并发AKI的显著危险因素。其中术前蛋白尿。肾脏体积缩小或弥漫性改变，血肌酐浓度增高为独立危险因素．术前必须谨慎评估风险和认真防治。
Objective： To explore and analyze the kidney risk factors which led to Acute Kidney Injury （AKI） after cardiac interventional therapy, as well as the relationship of the renal impairment and the incidence of AKI. Method： To retrospectively compare and analyze the clinical data of adult patients who undergone cardiac interventional therapy from January 2009 to January 2012 in our hospital. The serum creatinine values during 48 hours preand postoperation and the urine volumes per hour 48 hours after therapy were recorded to estimate the incidence of AKI. Regression analysis was conducted to demonstrate the correlations between preoperative kidney factors, such as elevated serum creatinine , urea nitrogen concentration, hematuria, proteinuria, abnormal kidney imaging, eGFR≤90 ml·min^-1· （1.73m2）-1 , and AKI after therapy. Results： In 152 patients adopted into our study, 33 patients （21.7%） developed AKI after cardiac interventional therapy. The patients with proteinuria, abnormal kidney imaging, elevated serum creatinine and urea nitrogen, eGFR ≤90 ml· min^-1 ·（1.73m2）-1 were correlated with AKI after therapy （P〈0.05 or 0.01）. eGFR levels and the onset of postoperative AKI were negatively correlated, that is, with lower eGFR levels, AKI incidence increased, especially when the eGFR ≤90 ml .min^-1 .（1.73m2）^-1. Logistic regression analysis indicated that proteinuria, abnormal kidney, elevated serum creatinine were independent risk factors for AKI. Conclusion： Proteinuria, abnormal kidney imaging, elevated serum creatinine and urea nitrogen and eGFR≤90 ml· min^-1· （1.73m2）-1 were significant risk factors of AKI after cardiac interventional therapy, and proteinuria, abnormal kidney, elevated serum creatinine concentration was an independent risk factor, which should be controlled carefully.
出处
《医学信息》
2012年第7期116-117,共2页
Journal of Medical Information
关键词
心脏介入治疗:急性肾损伤
肾小球滤过率
Cardiac interventional therapy
Acute kidney injury
Glomerular filtration rate
