2020 年第 7 期 第 15 卷

术前糖化血清白蛋白水平对冠状动脉旁路移植术后急性肾损伤发生风险的影响

Effect of preoperative glycosylated serum albumin level on the risk of acute renal injury after coronary artery bypass grafting

作者：高绪霞苏锋马立萍马涵英

英文作者：Gao Xuxia Su Feng Ma Liping Ma Hanying

单位：首都医科大学附属北京安贞医院全科医疗科100029 

英文单位：Department of General Practice Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠状动脉旁路移植术；糖化血清白蛋白；急性肾损伤

英文关键词：Cardiacarterybypassgrafting；Glycatedserumalbumin；Acutekidneyinjury

• 摘要：

• 目的研究术前糖化血清白蛋白（GA）水平对冠状动脉旁路移植术（CABG）患者术后急性肾损伤（AKI）发生风险的影响。方法回顾性分析2015年3—10月入住首都医科大学附属北京安贞医院心脏外科2 644例行CABG患者的病历资料。根据患者术后7 d内是否发生AKI分为AKI组及非AKI组。采用单因素及多因素Logistic 回归分析CABG患者术后发生AKI的危险因素。结果行CABG的2 644例患者中548例术后发生AKI，总AKI发生率为20.7%。多因素Logistic回归分析结果显示，GA≥21%、术前血肌酐增高、合并高血压、纽约心脏病协会心功能分级≥Ⅲ级、体外循环、联合多项手术为CABG手术后发生AKI的独立危险因素（比值比=1.778、1.748、11.713、14.252、2.359、750.660，95%置信区间：1.171～2.701、1.035～2.952、7.823～17.536、9.654～21.040、1.620～3.436、342.546～1 645.006，均P＜0.05），而女性是保护性因素（比值比=0.544，95%置信区间：0.386～0.768，P=0.001）。结论本研究收集的资料中CABG患者术后AKI发生率为20.7%，术前GA≥21%是术后AKI发生的独立危险因素。

• ObjectiveTo evaluate the effect of preoperative glycosylated serum albumin (GA) on the risk of acute renal injury (AKI) in patients undergoing coronary artery bypass grafting (CABG). Methods Totally 2 644 patients undergoing CABG surgery in the Department of Cardiac Surgery of Beijing Anzhen Hospital， Capital Medical University from March 2015 to October 2015 were analyzed retrospectively. The patients were divided into AKI group and non-AKI group. The risk factors of AKI after CABG were analyzed by single factor and multi factor Logistic regression. Results  Among the 2 644 patients who underwent CABG, 548 had AKI and the incidence rate was 20.7%. Multivariate logistic regression analysis showed that GA≥21%, preoperative serum creatinine increase, hypertension, New York Heart Association cardiac function grade≥Ⅲ, cardiopulmonary bypass and multiple operations were independent risk factors of AKI after CABG (odds ratio=1.778, 1.748, 11.713, 14.252, 2.359, 750.660, 95% confidence interval: 1.171-2.701, 1.035-2.952, 7.823-17.536, 9.654-21.040, 1.620-3.436, 342.546-1 645.006, all P＜0.05)； female was a protective factor (odds ratio=0.544, 95% confidence interval: 0.386-0.768, P=0.001). Conclusion The incidence of AKI after CABG surgery in the data collected in this study is 20.7%  and GA≥21% is an independent risk factor of AKI following CABG surgery.