【摘要】 目的探讨冠状动脉旁路移植术(CABG)后急性肾功能不全(ARI)的危险因素。方法回顾性分析1997年7月至2006年7月完成的2242例CABG的临床资料,统计术后ARI的发生率并对其危险因素进行分析。结果CABG术后219例发生ARI,占总例数的9.8%,单因素分析显示年龄≥70岁、糖尿病、术前慢性肾功能不全、左主干病变、射血分数(EF)≤0.35、急诊CABG、体外循环下CABG、升主动脉粥样硬化、术后呼吸功能不全与术后低心排与CABG术后ARI有关,Logistic多元回归分析提示年龄≥70岁(P=0.031)、术前慢性肾功能不全(肌苷清除率≤60ml/min,P=0.023或血清肌苷含量≥150μmol/L,P=0.041)、体外循环下CABG(P<0.001)、术后呼吸功能不全(P=0.013)与低心排综合征(P=0.004)是CABG术后ARI的独立危险因素。结论年龄≥70岁、术前慢性肾功能不全、体外循环下CABG、术后呼吸功能不全与低心排是影响CABG术后发生ARI的危险因素。更多还原

【Abstract】 Objective To study the risk factors of acute renal insufficiency(ARI)following coronary artery bypass grafting(CABG).Methods The clinic data of 2242 patients undertaking CABG between July 1997 and July 2006 were retrospectively analyzed,and ARI following CABG was included.Results ARI occurred in 219 patients,with an incidence of 9.8%.Univariate analysis revealed that advanced age,diabetes mellitus,preoperative chronic renal dysfunction,left main disease,low left ventricular erection faction,emergency operation,on-pump CABG,ascending aortic atherosclerosis,postoperative respiratory function insufficiency and low cardiac output syndrome were significantly related to ARI following CABG,and logistic multivariate regression analysis showed that presence of advanced age(P=0.031),preoperatively chronic renal dysfunction(CrCl ≤ 60 ml/min,P=0.023 or Scr≥150 μmol/L,P=0.041),on-pump CABG(P<0.001),postoperative respiratory function insufficiency(P=0.013)and low cardiac output syndrome(P=0.004)were independent risk factors of ARI.Conclusions Advanced age,preoperatively chronic renal dysfunction,on-pump CABG,postoperative respiratory function insufficiency and low cardiac output syndrome are the risk factors of ARI following CABG.更多还原