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[1]朱玉龙,鲁显福.心脏瓣膜术后发生急性肾损伤的危险因素分析[J].天津医科大学学报,2026,32(04):386-390.[doi:10.20135/j.issn.1006-8147.2026.04.0386]
　ZHU Yulong,LU Xianfu.A study on risk factors for acute kidney injury after cardiac valve surgery[J].Journal of Tianjin Medical University,2026,32(04):386-390.[doi:10.20135/j.issn.1006-8147.2026.04.0386]
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心脏瓣膜术后发生急性肾损伤的危险因素分析(PDF)

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
32卷
期数:
2026年04期
页码:
386-390
栏目:
论著
出版日期:
2026-07-10

文章信息/Info

Title:
A study on risk factors for acute kidney injury after cardiac valve surgery
文章编号:
1006-8147（2026）04-0386-05
作者:
朱玉龙1; 鲁显福2
（1.安徽医科大学附属安庆第一人民医院麻醉科，安庆 246003，2.安徽医科大学第一附属医院麻醉科，合肥 230022）
Author(s):
ZHU Yulong1;  LU Xianfu2
（1. Department of Anesthesiology， Anhui First People′s Hospital， Anhui Medical University， Anqing 246003， China； 2. Department of Anesthesiology， The First Affiliated Hospital of Anhui Medical University， Hefei 230022， China）
关键词:
心脏瓣膜手术; 急性肾损伤; 危险因素; 心血管不良事件
Keywords:
cardiac valve surgery;  acute kidney injury;  risk factors; major adverse cardiovascular events
分类号:
R654.2
DOI:
10.20135/j.issn.1006-8147.2026.04.0386
文献标志码:
A
摘要:
目的：探讨心脏瓣膜术后患者急性肾损伤（AKI）的危险因素。方法：采用回顾性研究，分析2018年1月至2019年12月安徽医科大学第一附属医院心脏外科行心脏瓣膜手术的446例成年患者的临床资料。根据术后是否发生AKI（诊断依据KDIGO标准）分为AKI组（n=90）和非AKI组（n=356）。比较两组一般资料、合并症、术前实验室指标（血红蛋白、肌酐、白蛋白、左室射血分数等）、术中情况（转机前后乳酸、体外循环时间、红细胞输注量等）及术后指标。采用单因素及多因素Logistic回归分析AKI的独立危险因素。结果：单因素分析表明，术后AKI的发生与术前糖尿病史、甲状腺功能亢进症、中重度肺动脉高压、心脏手术史、高肌酐、低血红蛋白、低红细胞比容、低白蛋白、低左室射血分数及术中高乳酸、高红细胞输注量、体外循环时间延长密切相关（均P<0.05）。糖尿病（OR=5.993，P<0.001）、甲状腺功能亢进症（OR=13.736，P=0.005）、转机前乳酸升高（OR=2.514，P<0.001）、术中红细胞输注量增加（OR=1.549，P<0.001）以及体外循环时间延长（OR=1.007，P=0.020）是术后发生AKI的独立危险因素。预后方面，相较于非AKI组，AKI组气管插管时间、ICU住院时间更长、呼吸衰竭发生率及全因死亡率更高（Z=2.003、4.879， χ2=12.495、7.613，均P<0.05）。结论：心脏瓣膜术后AKI的发生，与术前糖尿病、甲状腺功能亢进症及术中乳酸升高、红细胞输注量、体外循环时间等因素显著相关。
Abstract:
Objective： To investigate the risk factors of acute kidney injury （AKI） in patients after heart valve surgery. Methods： A retrospective study was conducted to analyze the clinical data of 446 adult patients who underwent cardiac valve surgery at the First Affiliated Hospital of Anhui Medical University from January 2018 to December 2019. The patients were divided into two groups based on whether AKI occurred after surgery （diagnosed according to the KDIGO criteria）： the AKI group （n=90） and the non-AKI group （n=356）. General information， comorbidities， preoperative laboratory indicators （hemoglobin， creatinine， albumin， left ventricular ejection fraction， etc.）， intraoperative conditions （lactate before and after bypass， cardiopulmonary bypass time， red blood cell tra-nsfusion volume， etc.）， and postoperative indicators were compared between the two groups. Univariate and multivariate Logistic regression analyses were used to identify the independent risk factors for AKI. Results： Univariate analysis showed that postoperative AKI was closely correlated with preoperative history of diabetes， hyperthyroidism， moderate to severe pulmonary hypertension， previous cardiac surgery， elevated creatinine， decreased hemoglobin， hematocrit， albumin and left ventricular ejection fraction， as well as intraoperative high lactic acid， increased red blood cell transfusion volume and prolonged cardiopulmonary bypass time （all P<0.05）. Diabetes mellitus （OR=5.993，P<0.001）， hyperthyroidism （OR=13.736， P=0.005）， elevated preoperative lactate （OR=2.514， P<0.001）， increased intraoperative red blood cell transfusion （OR=1.549， P<0.001）， and prolonged cardiopulmonary bypass time （OR=1.007， P=0.020） were independent risk factors for postoperative AKI. In terms of prognosis， compared with non-AKI group， the AKI group had longer tracheal intubation time and ICU stay， as well as higher incidence of respiratory failure and all-cause mortality （Z=2.003， 4.879， χ2=12.495，7.613， all P<0.05）. Conclusion： The occurrence of AKI after cardiac valve surgery is significantly associated with preoperative diabetes， hyperthyroidism， as well as intraoperative elevated lactic acid level， red blood cell transfusion volume and cardiopulmonary bypass duration.

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备注/Memo

备注/Memo:
（2025-12-26收稿）
作者简介 朱玉龙（2001-），男，医师，硕士在读，研究方向：胸心外科手术围术期管理；通信作者：鲁显福，E-mail：ahluxianfu@163.com。
更新日期/Last Update: 2026-07-15