首页|术前氨基末端脑钠肽前体(NT-proBNP)与肝移植术后急性肾损伤的关系探讨

术前氨基末端脑钠肽前体(NT-proBNP)与肝移植术后急性肾损伤的关系探讨

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目的 探究术前氨基末端脑钠肽前体(NT-proBNP)与肝移植术后急性肾损伤(AKI)的关系,明确肝移植术后AKI发生的影响因素,为早期预防肝移植术后AKI的发生提供诊断学参考指标.方法 回顾性收集吉林大学第一医院2020年9月13日—2022年6月30日行肝移植手术的成年患者病历资料.根据肝移植术后是否发生AKI将患者分为AKI组和非AKI组,采用倾向性评分匹配法(PSM)按照1∶4匹配两组患者基本信息.计量资料两组间比较采用成组t检验或Mann-Whitney U检验;计数资料两组间比较采用χ2检验或Fisher确切概率法.通过多因素Logistic回归分析肝移植术后AKI发生的独立危险因素.结果 共纳入144例肝移植患者,术后发生AKI者22例(15.3%),未发生AKI者122例(84.7%).经PSM平衡后共纳入93例患者,其中AKI组19例,非AKI组74例.多因素Logistic回归分析结果显示:术前NT-proBNP水平(OR=7.692,95%CI:1.473~40.159,P=0.016)、术前纤维蛋白原水平(OR=5.520,95%CI:1.160~26.267,P=0.032)、手术时长(OR=15.802,95%CI:2.418~103.268,P=0.004)和术中出血量(OR=13.246,95%CI:2.291~76.594,P=0.004)是肝移植术后患者发生AKI的独立危险因素.结论 术前NT-proBNP水平可作为肝移植术后AKI发生的预测指标,同时能够为构建肝移植术后AKI的风险预测模型提供一定的参考价值.
Association between preoperative N-terminal pro-brain natriuretic peptide and acute kidney injury after liver transplantation
Objective To investigate the association between preoperative N-terminal pro-brain natriuretic peptide(NT-proBNP)and acute kidney injury(AKI)after liver transplantation(LT),to clarify the influencing factors for AKI after liver transplantation,and to provide diagnostic reference indicators for the early prevention of AKI after LT.Methods A retrospective analysis was performed for the medical records of the adult patients who underwent LT in The First Hospital of Jilin University from September 13,2020 to June 30,2022,and according to the presence or absence of AKI after LT,the patients were divided into AKI group and non-AKI group.The propensity score matching(PSM)method was used to match the basic information of the two groups at a ratio of 1∶4.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups.The multivariate Logistic regression analysis was used to investigate the independent risk factors for AKI after LT.Results A total of 144 patients were included in this study,among whom 22(15.3%)developed AKI after surgery and 122(84.7%)did not develop postoperative AKI.A total of 93 patients were included after PSM,with 19 patients in the AKI group and 74 patients in the non-AKI group.The multivariate Logistic regression analysis showed that preoperative NT-proBNP(odds ratio[OR]=7.692,95%confidence interval[CI]:1.473-40.159,P=0.016),preoperative fibrinogen level(OR=5.520,95%CI:1.160-26.267,P=0.032),time of operation(OR=15.802,95%CI:2.418-103.268,P=0.004),and intraoperative blood loss(OR=13.246,95%CI:2.291-76.594,P=0.004)were independent risk factors for AKI after LT.Conclusion Preoperative NT-proBNP level may be used as a predictive factor for AKI after LT and can provide a certain reference for establishing a risk predictive model for AKI after LT.

Acute Kidney InjuryLiver TransplantationNT-proBNPRisk Factors

潘乃凡、宋雪松

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吉林大学第一医院麻醉科,长春 130021

急性肾损伤 肝移植 氨基末端脑钠肽前体 危险因素

吴阶平医学基金

320.6750.2022-3-34

2024

临床肝胆病杂志
吉林大学

临床肝胆病杂志

CSTPCD北大核心
影响因子:1.428
ISSN:1001-5256
年,卷(期):2024.40(8)