Abstract: 【Abstract】〓Objective〓To investigate risk factors and short-term outcomes of acute kidney injury (AKI).following CABG with extracorporeal circulation...Methods AKI was defined as relative 50% increase or an absolute increment of 26.4 umol/L in Scr within 48 hours and/or urine volume <0.5 ml·kg-1·h-1 up to 6h..According to the definition of AKI,.189 patients who received on-pump CABG from January 2007 to October 2013 were divided into acute renal injury group (AKI group, n=18) and non acute renal injury group(non AKI group,.n=171),.and were compared with clinical characteristics, complications and mortality. Results〓The incidence of AKI was 9.5% (18 cases). In-hospital mortality of AKI group was 22.2%, which was significantly higher than that of non-AKI group vs. (3.5%, P<0.05). Age in AKI group (70.22±9.52) was significantly higher than that in non-AKI group (vs. 63.94±10.79, P=0.019), as was Diabetes mellitus 55.6% vs 30.9% (P=0.035), hypertention 88.9% vs 62.7% (P=0.026), chronic obstructive pulmonary disease 11.1% vs 0.6% (P=0.024), EuroSCORE (The European System for Cardiac Operative Risk Evaluation) 5.94±3.09 vs 3.84±2.52 (P=0.002), extracorporeal circula-tion time 110.33±42.64 min vs 90.39±30.39 min(P=0.012),.with IABP 22.2% vs 7.1% (P=0.028), and postoperative glomerular filtration rate 31.10±15.20 vs 67.4±23.45 mL·min-1·1.73 m-2(P<0.001). Conclusion〓Age, Diabetes mellitus, hypertention, chronic obstructive pulmonary disease, EuroSCORE, extracorporeal circulation time, with IABP were risk factors of post-operative AKI for patients undergoing CABG with extracorporeal circulation. AKI was associated with higher mortality rate.

Key words: Coronary artery bypass grafting surgery, Extracoporeal circulation, Acute kidney injury, Risk factor, Prognosis

摘要： 【摘要】〓目的〓探讨体外循环下冠脉搭桥患者术后发生急性肾损伤(Acute kidney injury, AKI)的危险因素及预后。 方法〓根据AKI诊断标准:48 h血肌酐升高绝对值≥26.4 umol/L,或血肌酐较基础值升高≥50%;尿量减少(尿量<0.5 mL·kg-1·h-1,时间超过6 h),将2007年1月至2013年10月收治的189例体外循环下冠脉搭桥患者分为急性肾损伤组(AKI组,18例)和非急性肾损伤组(非AKI组,171例),比较二组临床特点及并发症和死亡率。结果〓AKI发生率9.5%(18例)。AKI组住院死亡率为22.2%,明显高于非AKI组3.5%(P<0.05)。AKI组与非AKI组在,平均年龄(P=0.019),糖尿病患病率(P=0.035),原发性高血压患病率(P=0.026),慢性阻塞性肺疾病患病率(P=0.024),EuroSCORE (The European System for Cardiac Operative Risk Evaluation)评分(P=0.002),术中体外循环时间(P=0.012),主动脉内球囊反搏(IABP)使用率(P=0.028),术后肾小球滤过率(P<0.001)等方面存在统计学差异。结论〓年龄、糖尿病、原发性高血压、慢性阻塞性肺疾病、EuroSCORE评分、术中体外循环时间、主动脉内球囊反搏(IABP)使用是体外循环下冠脉搭桥术后发生AKI的危险因素,发生AKI患者死亡风险较高。

关键词: 冠脉搭桥术, 体外循环, 急性肾损伤, 危险因素, 预后