摘要
目的系统评价急性心肌梗死(AMI)患者发生急性肾损伤(AKI)的影响因素。方法计算机检索PubMed、Embase、The Cochrane Library、中国知网、万方数据知识服务平台、维普网、中国生物医学信息数据库中建库至2022年9月30日关于AMI后发生AKI危险因素的文献。采用RevMan5.4、Stata15.1软件进行Meta分析。结果共纳入22篇文章,总样本量20198例。Meta分析结果显示:女性、高龄、高血压、糖尿病、慢性肾脏病、心力衰竭、陈旧性心肌梗死、周围血管病、脑梗死、高白细胞计数、低血小板计数、低白蛋白、高血肌酐、低钠、心室颤动、心率增快、Killip分级≥Ⅱ~Ⅲ级、ST段抬高型心肌梗死(STEMI)、广泛前壁心肌梗死、左心室舒张末期压低、左室射血分数低、未使用ACEI/ARB、未使用β受体阻滞剂、利尿剂、使用临时起搏器、实施主动脉球囊反搏术(IABP)、使用机械通气、实施冠状动脉旁路移植术(CABG)是AMI患者并发AKI的危险因素;高血脂、下壁心肌梗死、行PCI是AMI患者并发AKI的保护因素。结论临床可根据上述危险因素早期识别高危AMI患者,制订针对性预防措施,降低AKI发生率,改善患者预后。
Objective To systematically evaluate the influencing factors of acute kidney injury(AKI)in patients with acute myocardial infarction(AMI).Methods Databases of PubMed,Embase,Cochrane Library,CNKI,WanFang,VIP and SinoMed were searched to collect the articles on the risk factors of acute kidney injury in acute myocardial infarction from inception to October 2022.RevMan5.4 and Stata15.1 software were used for meta-analysis.Results A total of 22 articles were included,with a total sample size of 20198 cases.Meta-analysis showed that female,age,hypertension,diabetes,CKD,heart failure,prior myocardial infarction,peripheral vascular disease,cerebral infarction,high white blood cell count,low platelet,high blood creatinine,high creatinine,low albumin,low sodium,ventricular fibrillation,increased heart rate,Killip grade≥Ⅱ~Ⅲ,STEMI,extensive anterior myocardial infarction,low left ventricular ejection fraction(LVEF),low Left ventricular end diastolic pressure(LVEDP),no use of ACEI/ARB,no use ofβblockers,diuretics,use of temporary pacemaker,implementation of IABP,use of mechanical ventilation,implementation of CABG were risk factors for AKI in AMI patients.Hyperlipidemia,inferior myocardial infarction and PCI were protective factors for AKI in AMI patients.Conclusion Medical workers could early identify high-risk AMI patients according to the above risk factors,and formulate targeted preventive measures to reduce the incidence of AKI and improve the prognosis of patients.
作者
黎钰晴
木楠
何秋煜
陈名桂
张晓璇
Li Yuqing;Mu Nan;He Qiuyu;Chen Minggui;Zhang Xiaoxuan(Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;不详)
出处
《中国循证心血管医学杂志》
2023年第10期1153-1160,共8页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
2021年广东省科学技术厅海外名师项目(编号??)
广东省中医药局中医药科研项目(20212072)
广东省中医院中医药科学技术研究专项(YN2016HL03)
2021年度中医药高等教育学会临床教育研究会教育教学研究课题(2021016)
长春中医药大学临床实践教学改革专项研究课题(XJLCSJ202143)。
