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JASN：肾脏损伤标志物与心脏手术后远期心血管结局的关系如何？

2017-08-15 xing.T MedSci原创

肾脏损伤标志物心脏手术结局
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这些结果表明，在心脏手术时的临床AKI对并发CV具有指示作用，而不是一个独立的长期不良预后结局的肾脏表现。

通过测定血清肌酐升高来确定的临床AKI与心脏手术后不良心血管事件和死亡的长期风险有关。近日，肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章，为了评估尿液中肾脏损伤生物标记物和血浆中心脏损伤生物标记物在不良事件中的相对贡献，研究人员对968名接受心脏手术的成人进行了一项多中心前瞻性队列研究。

在受试者术后1-3天，研究人员测量了肾脏损伤的五种尿液生物标记物（IL-18、NGAL、KIM-1、L-FABP和白蛋白）和5种心脏损伤的血浆生物标志物（NT-proBNP、H-FABP、hs-cTnT、cTnI和CK-MB）。该研究的主要结局是长期心血管事件或死亡的复合，通过国家卫生保健数据库来进行评估。

在中位数为3.8年的随访中，219名（22.6%）患者经历了主要结局（136例心血管事件和83例额外死亡）。相比于无术后AKI的患者，那些经历了AKI的患者发生主要复合结局调整后的风险比为3.52（95%可信区间为2.17-5.71）。然而，五个尿液中肾脏损伤的生物标记物与主要结局没有显著相关性。相比之下，五个术后心肌损伤标志物中的四个标志物（NT-proBNP、H-FABP、hs-cTnT和cTnI）与主要结局密切相关。调解分析表明，心脏生物标记物解释了AKI与主要结局之间49%的关联度（95%可信区间为1%-97%）。

这些结果表明，在心脏手术时的临床AKI对并发CV具有指示作用，而不是一个独立的长期不良预后结局的肾脏表现。

原始出处：

Chirag R. Parikh,et al. Relationship of Kidney Injury Biomarkers with Long-Term Cardiovascular Outcomes after Cardiac Surgery.JASN,2017, http://jasn.asnjournals.org/content/early/2017/08/11/ASN.2017010055.abstract

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    2017-11-02 hukaixun

    #标志物#

    0

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    2018-04-15 chenhongpeng

    #ASN#

    0

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    2017-08-17 gous

    #心血管结局#

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    2017-08-17 ms3046638856685384

    #损伤#

    0

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    2017-08-16 龙胆草

    学习谢谢分享

    0