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年龄联合术后24h乳酸负荷对心脏瓣膜术后急性肾损伤的预测价值
莫基斌李水珠
[关键词]?心脏瓣膜；体外循环；急性肾损伤；乳酸负荷
[中图分类号]?R654??????[文献标识码]?A??????[DOI]?10.3969/j.issn.1673-9701.2024.06.014
Predictive?value?of?age?combined?with?postoperative?24-hour?lactic?acid?load?for?acute?kidney?injury?after?cardiac?valve?surgery
MO?Jibin1，?LI?Shuizhu2
1.Provincial?Clinical?College?of?Fujian?Medical?University，?the?Fourth?Department?of?Intensive?Care?Unit，?Fujian?Provincial?Hospital，?Fuzhou?350001，?Fujian，?China;?2.Department?of?Cardiology，?the?Affiliated?First?Hospital?of?Fujian?Medical?University，?Fuzhou?350004，?Fujian，?China
[Abstract]?Objective?To?investigate?the?relationship?between?postoperative?24h?lactic?acid?load?and?acute?kidney?injury?after?cardiac?valve?surgery?by?cardiopulmonary?bypass?in?adults.?Methods?The?clinical?data?of?180?patients?admitted?to?Fujian?Provincial?Hospital?for?heart?valve?operation?from?June?2019?to?August?2020?were?retrospectively?analyzed.?They?were?divided?into?acute?kidney?injury?（AKI）?group?（n=91）?and?non-AKI?group?（n=89）?according?to?the?occurrence?of?postoperative?AKI.?Univariate?and?multivariate?Logistic?analysis?was?performed?for?the?risk?factors?of?AKI?after?heart?valve?surgery，?and?receiver?operating?characteristic?（ROC）?curve?was?used?to?analyze?the?predictive?value?of?each?risk?factor?for?AKI?after?heart?valve?surgery.?Results?Univariate?analysis?showed?that?age，?time?of?cardiopulmonary?bypass，?off-pump?lactic?acid，?postoperative?24h?blood?loss，?postoperative?24h?positive?fluid?balance?and?postoperative?24h?lactic?acid?load?in?AKI?group?were?all?higher?than?those?in?non-AKI?group，?with?statistical?significance?（P0.05）.?The?results?of?multivariate?analysis?showed?that?age?and?postoperative?24h?lactic?acid?load?were?independent?risk?factors?for?AKI?after?heart?valve?surgery?（OR?values?were?1.064?and?1.014，?P0.05）.?ROC?curve?analysis?showed?that?age?and?postoperative?24h?lactic?acid?load?had?predictive?value?for?AKI?after?heart?valve?surgery，?and?the?combined?indexes?of?age?and?post
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