文章摘要
术前高敏C反应蛋白水平与成人心脏手术后急性肾损伤的相关性
Association between high sensitive C-reactive protein and acute kidney injury after adult cardiac surgery
  
DOI:10.12089/jca.2020.12.013
中文关键词: 高敏C反应蛋白  成人心脏手术  急性肾损伤
英文关键词: High sensitive C-reactive protein  Adult cardiac surgery  Acute kidney injury
基金项目:中国医学科学院临床与转化医学研究基金资助项目(2019XK320052)
作者单位E-mail
田宇 100037,北京协和医学院,阜外心血管病医院麻醉中心  
王越夫 100037,北京协和医学院,阜外心血管病医院麻醉中心 wangyuefu@hotmail.com 
赵韡 100037,北京协和医学院,阜外心血管病医院信息中心  
刁晓林 100037,北京协和医学院,阜外心血管病医院信息中心  
王薇薇 100037,北京协和医学院,阜外心血管病医院信息中心  
王春蓉 100037,北京协和医学院,阜外心血管病医院麻醉中心  
高宇晨 100037,北京协和医学院,阜外心血管病医院麻醉中心  
王苏徳娜 100037,北京协和医学院,阜外心血管病医院麻醉中心  
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中文摘要:
      
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17 339例,术后有5 231例(30.1%)发生AKI。术前hs-CRP>3 mg/L的患者有4 350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。
英文摘要:
      
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 17 339 patients, the overall prevalence of AKI after cardiac surgery was 30.1% (n = 5 231). There were 4 350 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.
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