血清 CIRP 对全主动脉弓置换术后急性肾损伤的预测价值

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiac Surgery Pub Date : 2024-08-01 DOI:10.1155/2024/4814978
Ke Chen, Dongxu Wang, Minhua Fang, Pengyu Wang, Peng Hou, Yu Liu, Liming Yu, Zijun Zhou, Juan Gao, Yong Zhang
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引用次数: 0

摘要

研究目的研究血清冷诱导 RNA 结合蛋白(CIRP)与全主动脉弓置换术后急性肾损伤(AKI)的预测价值。方法回顾性选取2019年10月至2021年2月入院的86例急性斯坦福A型主动脉夹层(ATAAD)患者作为研究对象。所有患者均在中度低体温循环停滞(MHCA)和选择性前向脑灌注(SACP)下接受了全主动脉弓置换术。研究人员收集并分析了患者入院后血清 CIRP 水平的检测结果以及围手术期的临床数据。肾病:改善全球预后(KDIGO)标准用于肾功能分期。根据术后肾功能分期,将患者分为非AKI-3组(70人)和AKI-3组(16人)。通过多变量逻辑回归模型分析了术后 AKI KDIGO 3 期的风险因素。采用接收者操作特征(ROC)曲线评估诊断效果。结果在86例患者中,术后AKI-3期占18.6%(16/86)。与非 AKI-3 期组相比,AKI-3 期组的术前 BMI 指数、C 反应蛋白和 CIRP 水平更高;术中降温时间、心肺旁路时间和主动脉交叉钳夹时间更长;术中冠状动脉旁路比例更高(所有 P 均为 0.05)。多变量逻辑回归结果显示,CIRP(OR = 1.001,95% CI:1.000-1.002,P = 0.012)是术后 AKI KDIGO 3 期的独立危险因素。结论血清 CIRP 与 ATAAD 患者全主动脉弓置换术后急性肾损伤有关,可作为早期发现和干预以改善预后的预测指标。
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Predictive Value of Serum CIRP in Acute Kidney Injury after Total Aortic Arch Replacement

Objectives. To investigate the predictive value of serum cold-inducible RNA-binding protein (CIRP) and postoperative acute kidney injury (AKI) after total aortic arch replacement. Methods. Eighty-six patients with acute Stanford type A aortic dissection (ATAAD) admitted to hospital from October 2019 to February 2021 were retrospectively selected as the study subjects. All patients underwent total aortic arch replacement under moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP). Detection of the level of serum CIRP after admission and perioperative clinical data of patients were collected and analyzed. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to stage renal function. Patients were divided into a non-AKI-3 group (n = 70) and an AKI-3 group (n = 16) according to the stage of postoperative renal function. The risk factors for postoperative AKI KDIGO stage 3 were analyzed by a multivariate logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy. Results. In 86 patients, postoperative AKI-3 stage accounted for 18.6% (16/86). Compared with the non-AKI-3 group, the AKI-3 group had a higher preoperative BMI index, C-reactive protein, and CIRP level; a longer intraoperative cooling time, cardiopulmonary bypass time, and aortic cross-clamping time; and a higher intraoperative coronary artery bypass ratio (all P < 0.05). Multivariate logistic regression results showed that CIRP (OR = 1.001, 95% CI: 1.000–1.002, P = 0.012) was an independent risk factor for postoperative AKI KDIGO stage 3. Conclusion. The serum CIRP is associated with postoperative acute kidney injury after total aortic arch replacement in ATAAD patients and may serve as a predictive indicator for early detection and intervention to improve the prognosis.

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来源期刊
CiteScore
2.90
自引率
12.50%
发文量
976
审稿时长
3-8 weeks
期刊介绍: Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.
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