急性心肌梗死发生急性肾损伤的危险因素分析

Analysis of Risk Factors for Acute Kidney Injury in Acute Myocardial Infarctio

目的 分析急性心肌梗死(AMI)患者发生急性肾损伤的危险因素。方法 纳入我院2020年12月至2022年11月急诊科收治的496例急性心肌梗死患者,根据其救治期间急性肾损伤(AKI)发生情况分为非AKI组(447例)与AKI组(49例),比较两组患者基线资料及临床治疗情况,应用多因素Logistic回归分析AKI发生的危险因素。结果 多因素逻辑回归结果显示高龄、既往糖尿病史、血肌酐升高、基础eGFR下降、高Killip心功能分级、左心室射血分数下降是老年AMI患者发生AKI的独立危险因素,而72 h内行PCI治疗是AKI的独立保护因素。结论 在老年、糖尿病及心肾功能损伤的AMI患者发生AKI的风险较大,而AMI发病后及时行PCI治疗可减少AKI发生的风险。

Objective To analyze the risk factors for the occurrence of acute kidney injury in patients with acute myocardial infarction(AMI).Methods A total of 496 AMI patients with admitted to emergency department of our hospital from December 2020 to November 2022 were included,and they were divided into the group non-AKI(447 cases) and AKI group(49 cases) according to the occurrence of acute kidney injury(AKI) during the hospitalization,and the baseline data and clinical treatments of the patients in the two groups were compared,and the multivariate logistic regression was applied to analyze the risk factors for AKI.Results The multivariate logistic regression showed that advanced age,previous history of diabetes mellitus,elevated blood creatinine,decreased basal eGFR,high Killip cardiac function grade,and decreased left ventricular ejection fraction were the independent risk factors for AKI in AMI patients,and PCI treatment within 72 hours after AMI was an independent protective factor for AKI.Conclusions The risk of AKI is higher in elderly,diabetes and cardiac and renal impairment patients with AMI,while timely PCI treatment after AMI can reduce the risk of AKI.