中国体外生命支持2026，Vol.24Issue(2)：103-108,121,7.DOI:10.13498/j.cnki.chin.j.ecls.2026.02.04
A型主动脉夹层术后急性肾损伤的中期预后及相关危险因素分析
Mid-Term Prognosis and Associated Risk Factors of Acute Kidney Injury Following Surgery for Stanford Type A Aortic Dissection
摘要
Abstract
Objective To investigate the medium-term prognosis and related risk factors of acute kidney injury(AKI)af-ter surgery for Stanford type A aortic dissection(TAAD),and to provide evidence for the formulation of targeted clinical interven-tion strategies.Methods A total of 250 TAAD patients who underwent surgical treatment for TAAD at the First Affiliated Hos-pital of Air Force Medical University from January to December 2023 were enrolled.Their baseline data,surgical parameters,and postoperative recovery data were collected.According to KDIGO 2012 criteria,patients were divided into AKI group(165 cases)and non-AKI group(85 cases).Patients were followed up for 6 months and 1 year postoperatively to record changes in renal func-tion,complications,and survival.Multivariate Logistic regression was used to analyze the influencing factors of medium-term prognosis.Results At 6 months after surgery,the incidence of chronic kidney disease(CKD)in the AKI group was 38.8%,which was significantly higher than 11.8%in the non-AKI group(P<0.001).The 1-year follow-up showed that the cumulative survival rate in the AKI group was 76.4%,lower than 91.8%in the non-AKI group(P=0.002).Multivariate analysis indicated that preoperative hypertension history(OR=2.842,95%CI:1.456-5.547),preoperative white blood cell count≥10.58×109/L(OR=2.315,95%CI:1.183-4.531),postoperative 3-day hemoglobin<105 g/L(OR=3.107,95%CI:1.589-6.075),and AKI dura-tion≥72h(OR=4.263,95%CI:2.198-8.268)were independent risk factors for 1-year adverse prognosis.Conclusion Patients with AKI following TAAD surgery exhibit a high medium-term CKD incidence and lower survival rates.Preoperative hyperten-sion,elevated white blood cell count,postoperative anemia,and prolonged AKI duration are key factors influencing prognosis.Early clinical intervention is needed to improve the medium-term outcomes of patients.关键词
Stanford A型主动脉夹层/大血管手术/急性肾损伤/危险因素/中期预后Key words
type A aortic dissection/great vessel surgery/acute kidney injury/risk factors/medium-term prognosis引用本文复制引用
徐博,朱鹏举,黄利,刘金成,金振晓,段维勋,俞波,任恺,刘大伟,薛超,王伟光,杨静,王立伟..A型主动脉夹层术后急性肾损伤的中期预后及相关危险因素分析[J].中国体外生命支持,2026,24(2):103-108,121,7.基金项目
国家自然科学基金(82370273) （82370273）
西京医院院级助推一般项目(XJZT24JC37) （XJZT24JC37）
