【摘要】 目的:研究术后血清总胆红素水平(TBIL)与心脏体外循环术后急性肾损伤发生的关系,评估其对体外循环术后急性肾损伤发生的预测价值。方法:回顾性分析2018年1月至2019年8月,在我院行体外循环手术的230例患者临床资料,收集患者术后48 h TBIL水平,根据水平,将患者分为TBIL>34.2μmol/L和正常胆红素组。比较两组患者的年龄、性别、合并症、肝功能指标(GOT,GPT)、手术时间、术中输液量、血清肌酐水平、术后发生急性肾损伤情况及连续性肾脏替代治疗使用率等。结果:研究对象中共有68例患者(29.6%)纳入高胆红素组,其中30例患者(44.1%)发生急性肾损伤(OR=3.673,95%CI:1.984～6.230,P<0.001)。校正后行多因素Logistic回归分析显示,术后高胆红素血症、年龄、心功能分级、术前合并症(高血压、糖尿病)、BMI>30 kg/m~2、体外循环时间、术后低血压与急性肾损伤相关(P<0.05)。结论:高胆红素血症是心脏体外循环术后急性肾损伤发生的危险因素。更多还原

【Abstract】 Objective: To investigate the relationship between postoperative serum total bilirubin level(TBIL) and acute renal injury after cardiopulmonary bypass(CPB),and to evaluate its predictive value for acute renal injury(AKI). Methods: A retrospective analysis was made on 230 patients who underwent cardiopulmonary bypass in our hospital from January 2018 to August 2019. Patients were divided into high-bilirubin group(TBIL>34.2 μmol/L) and the normal bilirubin group,based on the serum bilirubin levels 48 hours after surgery.The age, sex, comorbidity, GOT, GPT, operative time, intraoperative infusion volume, serum creatinine level, postoperative acute kidney injury(AKI) and continuous renal replacement therapy were compared between the two groups. Results: A total of 68 patients(29.6%) were included in the high-bilirubin group, and 30 patients(44.1%) developed postoperative AKI(OR=3.673,95%CI: 1.984-6.230,P<0.001). Multivariate Logistic regression analysis showed that age, diabetes, hypertension, preoperative hyperbilirubinemia, BMI>30 kg/m~2,CPB time,postoperative hypotension were associated with postoperative AKI. Conclusions: Hyperbilirubinemia might be regarded as an independent risk factor of AKI following cardiac surgery.更多还原