非体外循环下冠脉搭桥患者术前白蛋白水平与术后急性肾功能损伤的关系

The relationship between preoperative albumin level and postoperative acute kidney injury following off-pump coronary artery bypass surgery

目的:研究非体外循环下冠脉搭桥(OPCAB)患者术前白蛋白水平与术后急性肾功能损伤(AKI)的关系;明确术后肾功能良好和发生AKI的白蛋白界值。方法:回顾性队列研究。搜集了两年来的OPCAB患者的病例资料,使用KIDGO标准诊断AKI。结果:广义相加模型和多因素Logistic回归分析显示,术前白蛋白水平越高,术后AKI的发生率越低。通过广义相加模型、多因素Logistic回归分析和ROC曲线三个模型,确定术后肾功能良好和发生AKI的白蛋白界值介于39~40 g/L之间。结论:对于接受OPCAB术的患者,术前白蛋水平越高,术后AKI的发生率越低。为减少OPCAB术患者术后AKI的发生率,应维持术前白蛋白水平高于40 g/L。

Objective To investigate the relationship between preoperative albumin level and postoperative acute kidney injury （AKI） following off-pump coronary artery bypass （ OPCAB ） surgery ; to confirm albmnin cut- off value associated with AKI. Method This was a retrospective cohort study, data from patients who accepted OPCAB surgery in last two years in our hospital and AKI was diagnosed according to KIDGO- AKI criteria. Results Generalized additive model and multivariable logistic regression analysis have shown that the higher preoperative albumin level is related with the lower the incidence of AKI after OPCAB surgery. By generalized additive model, multivariable logistic regression analysis and ROC curve, we confirmed the albumin cut-off value associated with AKI between 39-40 g/L. Conclusion For patients undergoing OPCAB surgery, the higher preoperative albumin level, the lower the incidence of AKI. In order to reduce the incidence of AKI in OPCAB surgery patients, preoperative albumin level higher than 40 g/L should be maintained.