急性ST段抬高型心肌梗死老年患者发生急性肾损伤的危险因素分析

Add to Favorite Get Latest Update An analysis of risk factors for acute kidney injury in elderly patients with acute ST-segment elevation myocardial infarction

目的分析急性ST段抬高型心肌梗死(STEMI)老年患者发生急性肾损伤(AKI)的危险因素。方法95例STEMI老年患者根据住院期间是否发生AKI分为AKI组(32例)和非AKI组(63例),比较两组临床资料、实验室指标、接受药物及手术治疗、STEMI相关病情及住院期间主要不良心血管事件(MACE)发生情况,分析STEMI老年患者发生AKI的危险因素。结果与非AKI组比较,AKI组年龄较大,HR较快,CRP、SCr、BUN、血清尿酸、D-D、B型脑钠肽水平较高,高尿酸血症、利尿剂使用、Killip分级≥Ⅲ级和发生MACE者比例较高,而估算肾小球滤过率(eGFR)和左心室射血分数(LVEF)以及有吸烟史和经皮冠状动脉介入治疗者比例较低(P<0.05)。年龄增大、LVEF降低和Killip分级≥Ⅲ级是STEMI老年患者发生AKI的独立危险因素(P<0.05)。结论年龄增大、LVEF降低和Killip分级≥Ⅲ级是STEMI老年患者发生AKI的危险因素。

Objective To analyze the risk factors for acute kidney injury(AKI)in the elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods According to whether AKI occurred during hospital stay,95 elderly patients with STEMI were divided into AKI group(32 cases)and non-AKI group(63 cases).Clinical data,laboratory indicators,drug and surgical treatment,STEMI-related conditions and occurrence of major adverse cardiovascular events(MACE)during hospital stay were compared between the two groups.The risk factors for AKI in the elderly patients with STEMI were analyzed.Results Compared with non-AKI group,AKI group had increased age and faster HR,higher levels of CRP,SCr,BUN,UA,D-D,B-type brain natriuretic peptide,higher proportions of the patients with hyperuricemia,diuretic use,Killip grade≥Ⅲand MACE occurrence,lower levels of estimated glomerular filtration rate,left ventricular ejection fraction(LVEF),and lower proportions of the patients with smoking history and percutaneous coronary intervention(P<0.05).Increased age,decreased LVEF and Killip grade≥Ⅲwere the independent risk factors for AKI in the elderly patients with STEMI(P<0.05).Conclusion Increased age,decreased LVEF and Killip grade≥Ⅲare the risk factors for AKI in the elderly patients with STEMI.