摘要
目的分析术前高敏C反应蛋白(hs-CRP)水平与成人心脏手术后急性肾损伤(AKI)的相关性。方法本研究为回顾性病例-对照研究。收集2017年1月至2018年12月行开放心脏手术的成年患者病历资料。根据改善全球肾脏病预后组织(KDIGO)标准判断AKI。采用多因素Logistic回归分析评估术前hs-CRP水平>3 mg/L与术后AKI的相关性。结果本研究共纳入患者17339例,术后有5231例(30.1%)发生AKI。术前hs-CRP>3 mg/L的患者有4350例(25.1%)。单因素分析显示,AKI患者术前存在hs-CRP>3 mg/L的比例明显高于非AKI患者(30.5%vs 24.8%,P<0.001)。在校正了性别、年龄、既往史、术前心功能、术前肾功能、术中输血情况等因素后,术前hs-CRP>3 mg/L是成人心脏术后发生AKI的独立危险因素(OR=1.145,95%CI 1.052~1.246,P=0.002)。结论术前hs-CRP水平>3 mg/L会增加心脏术后AKI的发生风险。
Objective To investigate the association between preoperative serum high sensitive C-reactive protein(hs-CRP)and acute kidney injury(AKI)after adult cardiac surgery.Methods Adult patients underwent cardiac surgery from January,2017 to December,2018 were enrolled into retrospective study.AKI was defined according to Kidney Disease:Improving Global Outcomes(KDIGO)criteria.The Logistic regression analysis was used to analyze the association between preoperative hs-CRP>3 mg/L and AKI.Results Among the 17339 patients,the overall prevalence of AKI after cardiac surgery was 30.1%(n=5231).There were 4350 patients(25.1%)whose preoperative serum hs-CRP>3 mg/L.The proportion of AKI patients with hs-CRP>3 mg/L before operation was significantly higher than that of non-AKI patients(30.5%vs 24.8%,P<0.001).After adjusting the effect of age,gender,past history,preoperative cardiac function,preoperative renal function,intraoperative blood transfusion,and other covariates,the multivariable Logistic regression analysis showed that preoperative serum hs-CRP>3 mg/L was an independent risk factor of AKI after cardiac surgery(OR=1.145,95%CI 1.052-1.246,P=0.002).Conclusion Preoperative serum hs-CRP>3 mg/L can increase the probability of occurrence of AKI after adult cardiac surgery.
作者
田宇
王越夫
赵韡
刁晓林
王薇薇
王春蓉
高宇晨
王苏徳娜
TIAN Yu;WANG Yuefu;ZHAO Wei;DIAO Xiaolin;WANG Weiwei;WANG Chunrong;GAO Yuchen;WANG Sudena(Anesthesiology Center,Fuwai Hospital,Peking Union Medical College,Beijing 100037,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2020年第12期1201-1205,共5页
Journal of Clinical Anesthesiology
基金
中国医学科学院临床与转化医学研究基金资助项目(2019XK320052)。
关键词
高敏C反应蛋白
成人心脏手术
急性肾损伤
High sensitive C-reactive protein
Adult cardiac surgery
Acute kidney injury
