目的研究左西孟旦对重症冠状动脉搭桥术后急性肾损伤的影响。方法前瞻性纳入2013年12 月～2015 年6 月期间北京阜外医院成人外科恢复室收治的3 支病变或合并左主干病变，行冠状动脉旁路移植(coronary artery bypass graft,CABG)手术治疗的冠状动脉粥样硬化性心脏病患者资料。随机分为左西孟旦组及对照组，2 组按外科术后常规治疗，左西孟旦组在此基础上加用左西孟旦静脉泵入。结果共79 例患者入选，其中左西孟旦组44 例，对照组39 例。术后2 组患者肌酐水平均较术前增高，左西孟旦组患者肌酐从第3 日起低于对照组[(102.0±14.7）μmol/L 比(137.0±21.4)μmol/L], T 值2.540,P=0.015。左西孟旦组术后共8 例诊断为AKI(8/36),对照组共14 例诊断为AKI(14/21)，χ²=4.620，P 值=0.032。出院时左西孟旦组患者肌酐水平小于对照组[(94.0±16.7)μmol/L 比(119.0±17.6)μmol/L], t 值2.540, P= 0.017。多因素logistic 回归示左西孟旦是术后AKI 的保护性因素，OR 值为0.680(0.420～0.870)。结论左西孟旦降低重症冠状动脉搭桥术后急性肾损伤的发生。

Objective To investigate the effects of Levosimendan on acute kidney injury in patients undergoing coronary artery bypass grafting. Methods Patients with severe coronary artery bypass grafting were prospectively enrolled during December 2013 to June 2015 in Fuwai Hospital,randomized to levosimendan-treated group and control group.Results : 79patients were enrolled in the research,44patients in levosimendan-treated group and 35patients in control group.The creatinine were both increased in the two groups compared to baseline.The levosimendan group had lower creatinine than control group from Day 3,p<0.05 .The incidence of AKI in levosimendan group was less than control group.Multivariate logistic regression showed that levosimendan was the protective factor of postoperative AKI, OR :0.68(0.42~0.87). Conclusion Levosimendan reduced the incidence of AKI in the patients undergoing severe coronary artery bypass grafting.