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目的:对急性心肌梗死(AMI)后并发急性肾损伤(AKI)患者的临床特征进行分析并探讨并发急性肾损伤的危险因素。方法:回顾性分析148例AMI后并发AKI患者的临床资料并设为观察组,并选取50例单纯AMI患者的临床资料作为对照组进行比较,分析AMI并发AKI患者的临床特征及危险因素。结果:观察组患者病死率、年龄、高血压病史、糖尿病史、慢性肾脏疾病史发生率显著高于对照组(P<0.01,P<0.05),住院时间、病变血管数、发病至入院时间、Killip分级、左室射血分数以及N前端脑钠肽(NT-proBNP)水平差异有统计学意义(P<0.01,P<0.05)。多因素分析证实,高血压病史、慢性肾脏疾病史、发病至住院时间>6h、入院Killip分级>2级是发生AKI的危险因素。结论:AMI后并发AKI患者的病死率高,高血压病史、慢性肾脏疾病史、发病至住院时间>6h、入院Killip分级>2级是AKI发生的独立危险因素。
Objective: To analyze the clinical characteristics of patients with acute renal injury (AKI) after acute myocardial infarction (AMI) and to explore the risk factors of acute kidney injury. Methods: The clinical data of 148 patients with AMI complicated with AKI were retrospectively analyzed. The clinical data of 50 patients with AMI were selected as the control group. The clinical characteristics and risk factors of AMI complicated with AKI were analyzed. Results: The incidence of mortality, age, history of hypertension, history of diabetes and history of chronic kidney disease in observation group were significantly higher than those in control group (P0.01, P0.05), length of hospital stay, number of vascular lesions, time from onset of illness to admission, Killip grade, left ventricular ejection fraction and N-terminal proBNP (P <0.01, P <0.05). Multivariate analysis confirmed that the history of hypertension, history of chronic kidney disease, onset to hospitalization> 6h, admission Killip grade> 2 is a risk factor for the occurrence of AKI. Conclusions: The mortality rate, history of hypertension and chronic kidney disease in patients with AKI complicated with AMI are higher than those in patients with AMI. The incidence of hospital stay> 6 hours and admission Killip grade> 2 are independent risk factors of AKI.