中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (01): 21-24.doi: 10.3969/j.issn.1671-4091.2013.01.00

• 临床研究 • 上一篇    下一篇

老年人心脏术后急性肾损伤的临床研究

滕杰1,许佳瑞2,方艺2   

  1. 1. 复旦大学附属中山医院肾内科、血液净化中心
    2. 上海复旦大学附属中山医院
  • 收稿日期:2012-05-15 修回日期:2012-09-07 出版日期:2013-01-12 发布日期:2013-01-04
  • 通讯作者: 丁小强 ding.xiaoqiang@zs-hospital.sh.cn E-mail:Jie.teng@zs-hospital.sh.cn
  • 基金资助:
    教育部“211”重大项目(211XK60)；上海市医学发展基金重点课题(2003ZD001)；国家十二五支撑计划课题(2011BAI10B07)。

Preliminary research on acute kidney injury after cardiac surgery in elderly people

  • Received:2012-05-15 Revised:2012-09-07 Online:2013-01-12 Published:2013-01-04

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摘要： 【摘要】目的 分析不同年龄段成人患者心脏术后急性肾损伤（AKI）发病状况，以指导研究进一步防治措施。方法 前瞻性收集接受心脏外科手术住院患者病史资料，分析不同年龄段患者心脏手术后AKI发病率、发病危险因素及短期预后。结果 共入选3896例接受心脏手术治疗患者。其中中青年（＜65岁，但≥18岁）患者3086例、老年（≥65岁，但＜80岁）患者772例、高龄（≥80岁）患者38例。老年组术前血肌酐、男性、术前心功能NYHA Ⅲ级、术前合并糖尿病、高血压及造影史比例、接受冠状动脉旁路移植术、术后因低血压使用肾上腺素及去甲肾上腺素比例均高于中青年组（P值均1.2mg/dl、术后因低血压使用肾上腺素。结论 老年人心脏术后AKI随患者年龄增加而逐步升高且预后较差，其发病与围手术期多种危险因素密切相关。老年人心脏术后并发AKI时仍应积极救治，以期进一步改善患者预后

关键词: 心脏手术, 老年人, 急性肾损伤, 院内死亡率, 预后, 危险因素

Abstract: 【Abstract】Background The aim of the present study was to analyze the current situation of AKI after cardiac surgery of adults with different age to investigate the possibility of prophylaxis and treatment. Methods We prospectively collected data from patients who underwent cardiac surgery from April 2009 to May 2011 and analyze the incidence and risk factors of AKI after surgery and short-term clinical outcomes of different ages. Results 3896 patients were included. There were 3086 patients in young and middle-aged group(18~65), 772 patients in elderly group(65~80) and 38 patients in senile group(≥80). The male proportion, preoperative serum creatinine, NYHA III grade, preoperative diabetes mellitus, hypertension and coronary angiography, proportion of CABG surgery, proportion of use of adrenaline and noradrenaline for hypotension in elderly group were significantly higher than in young and middle-aged group(all P1.2mg/dl, post-operative use of adrenaline for hypotension were independent risk factors of AKI after cardiac surgery of people over 65years old. Conclusions The AKI incidence after cardiac surgery in elderly people was increased with age and with high mortality. The incidence of AKI was related to a number of perioperative risk factors. Elderly people that occurred AKI after cardiac surgery should also get positive treatment to improve outcomes.

Key words: Cardiac surgery, Elderly people, Acute kidney injury, Hospital mortality, Outcome, Risk factors