摘要
目的分析冠状动脉造影检查后行瓣膜置换术患者的肾功能变化,总结术前冠状动脉造影检查是否会增加术后急性肾损伤的发生率。方法收集2013年1月至2015年9月西南医科大学附属医院心胸外科收治638例行心脏瓣膜置换术患者的临床资料,其中118例术前行冠状动脉造影检查(冠状动脉造影检查组),520例未行冠状动脉造影(非冠状动脉造影检查组)。在患者手术前(T0),术后12 h(T1)、24 h(T2)、48 h(T3)4个时间点测量血清肌酐(Scr)、尿素氮(Bun)、脑钠肽(BNP)、血清磷酸肌酸激酶同功酶(CK-MB)、心肌肌钙蛋白I(cTnI)值,并记录术后48 h急性肾损伤发生的例数。结果尽管与非冠状动脉造影检查组比较,冠状动脉造影检查组的术后24 h和48 h Scr值增加[(91.6±37.7)μmol/L vs(.81.0±27.4)μmol/L,(84.9±23.6)μmol/L vs(.73.5±25.3)μmol/L],且差异有统计学意义;但两者急性肾损伤的发生率和心肌酶各项指标差异均无统计学意义。结论术前冠状动脉造影检查并不会增加患者术后急性肾损伤的发生率。
Objective To explore whether preoperative coronary angiography could increase the incidence of postoperative acute kidney injury for patients with valve replacement. Methods A total of 638 patients underwent routine cardiac valve replacement in our hospital from January 2013 through September 2015. There were 118 patients with preoperative coronary angiography （a coronary angiography group）, and 520 patients without coronary angiography （a non-coronary angiography group）. Serum creatinine （Scr）, urea nitrogen（Bun）, brain natriuretic peptide （BNP）, creatine kinase myocardial band （CK-MB）, cardiac troponin I （cTnI） values were recorded at 4 time points： before surgery （TO）, after surgery 12 h （T1）, 24 h （T2）, 48 h （T3）. The number of patients with acute kidney injury at the time of 48 hours after surgery was recorded. Results Scr values （91.6±37.7 μmol/L vs. 81.0±27.4 μmol/L, 84.9±23.6 μmol/L vs. 73.5±25.3 μmol/L） increased in the patients who did not undergo coronary angiography at the time of 24 hours and 48 hours after cardiac surgery compared with the patients with coronary angiography with statistical differences. While there was no statistical difference in the incidence of acute kidney injury between the two groups. The cardiac enzymes had no statistical difference between the two groups. Conclusion Preoperative coronary angiography does not increase the probability of postoperative acute kidney injury.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2016年第9期894-897,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
冠状动脉造影
急性
肾损伤
瓣膜病
心脏手术
Coronary artery angiography
Acute kidney injury
Valvular disease
Cardiac surgery
