神经药理学报2025，Vol.15Issue(6)：28-35,8.DOI:10.3969/j.issn.2095-1396.2025.06.004
高密度脂蛋白胆固醇与体外循环心脏手术后急性肾损伤相关性分析
Association of High-Density Lipoprotein Cholesterol with Acute Kidney Injury after Cardiac Surgery with Cardiopulmonary Bypass
摘要
Abstract
Objective:To analyze the association between preoperative high-density lipoprotein cholesterol(HDL-C)and acute kidney injury(AKI)in patients after cardiac surgery with cardiopulmonary bypass(CPB).Methods:We conducted a retrospective analysis of clinical data from adult patients who underwent cardiac surgery with CPB.The patients were divided into low HDL-C level group(<1.04 mmol·L-1)and normal HDL-C level group(≥1.04 mmol·L-1)according to the preoperative blood lipid level.The clinical data and the incidence of postoperative AKI within 7 days after surgery were compared between the two groups.Univariate analysis and binary Logistic regression analysis were used to evaluate the effect of preoperative HDL-C concentration on postoperative AKI.Results:Among the 903 patients included,326 cases in the low level HDL-C group(36.1%)and 577 cases(63.9%)in the normal level HDL-C group.351 cases(38.9%)had AKI after cardiac surgery with CPB,of which 156 cases(47.9%)in the low level HDL-C group and 195 cases(33.8%)in the normal level HDL-C group,and the difference was statistically significant(P<0.001).Compared with the normal level HDL-C group,the incidence of postoperative AKI in the low level HDL-C group was higher(P<0.001),and the ventilator use time,the duration of ICU and the length of stay were prolonged(P<0.001).After adjusted for age,gender,comorbidities(hypertension,diabetes),anemia,hyperuricemia,hypoalbuminemia,proteinuria,preoperative renal function,preoperative cardiac function,preoperative coronary angiography,cardiopulmonary bypass time,aortic clamping time,type of cardiac surgery,postoperative hypotension and other influencing factors,binary Logistic regression analysis showed that preoperative low level HDL-C was an independent risk factor for AKI in patients after cardiac surgery with CPB(OR=1.413,95%CI 1.023～1.950,P=0.036).Conclusion:AKI is a common complication after cardiac surgery with CPB,and identify preoperative low HDL-C is an independent risk factor for AKI.关键词
高密度脂蛋白胆固醇/心脏手术/体外循环/急性肾损伤Key words
high-density lipoprotein cholesterol/acute kidney injury/cardiac surgery/cardiopulmonary bypass分类
医药卫生引用本文复制引用
LIU Liu,LIU Fu-gang,XIE Kai-qing..高密度脂蛋白胆固醇与体外循环心脏手术后急性肾损伤相关性分析[J].神经药理学报,2025,15(6):28-35,8.基金项目
广西壮族自治区自然科学基金项目(No.2018GXNSFAA050057) （No.2018GXNSFAA050057）
