急性冠脉综合征相关急性肾损伤临床研究进展
Advances in Clinical Research on Acute Kidney Injury Associated with Acute Coronary Syndromes
DOI: 10.12677/ACM.2024.142424, PDF,   
作者: 王润泽, 李素华*：新疆医科大学第一附属医院肾脏疾病中心，省部共建中亚高发病成因与防治国家重点实验室， 新疆 乌鲁木齐；新疆维吾尔自治区肾脏病研究所，新疆 乌鲁木齐；新疆肾脏替代治疗临床医学研究中心，新疆 乌鲁木齐
关键词: 急性冠脉综合征；急性肾损伤；危险因素；Acute Coronary Syndrome； Acute Kidney Injury； Risk Factors
摘要: 急性肾损伤(Acute kidney injury, AKI)为各种原因所致的短期内肾功能迅速减退，主要表现为肾小球滤过率(GFR)下降，伴有如尿素、肌酐等氮质产物在体内蓄积，水、电解质及酸碱平衡紊乱的临床综合征。同时也是心血管疾病干预治疗后出现的主要不良事件之一。急性冠脉综合征(Acute coronary syndrome, ACS)作为冠心病主要分类之一，也是急诊急危重症之一，本综述在急性冠脉综合征患者治疗后急性肾损伤的发病机制、危险因素等方面加以论述，以期为急性冠脉综合征患者预防AKI提供指导。
Abstract: Acute kidney injury (AKI) is a clinical syndrome in which kidney function declines rapidly in the short term due to a variety of causes, manifesting mainly as a decrease in glomerular filtration rate (GFR), accompanied by accumulation of nitrogen products such as urea and creatinine in the body, and disturbances in water, electrolytes and acid-base balance. It is also one of the most common adverse events following cardiovascular interventions. As one of the main categories of coronary artery disease and one of the acute and critical emergency conditions, this review discusses the pathogenesis and risk factors of post-treatment acute kidney injury in patients with acute coronary syndrome to provide guidance for the prevention of AKI in patients with acute coronary syndrome.
文章引用：王润泽, 李素华. 急性冠脉综合征相关急性肾损伤临床研究进展[J]. 临床医学进展, 2024, 14(2): 2994-3003. https://doi.org/10.12677/ACM.2024.142424

参考文献

[1] Marenzi, G., Cosentino, N. and Bartorelli, A.L. (2015) Acute Kidney Injury in Patients with Acute Coronary Syndromes. Heart, 101, 1778-1785. [Google Scholar] [CrossRef] [PubMed]
[2] Ronco, C., et al. (2008) Cardiorenal Syndrome. Journal of the American College of Cardiology, 52, 1527-1539. [Google Scholar] [CrossRef] [PubMed]
[3] Zhang, X., et al. (2023) Clinical Outcomes for Acute Kidney Injury in Acute Myocardial Infarction Patients after Intra-Aortic Balloon Pump Implantation: A Single-Center Observational Study. Reviews in Cardiovascular Medicine, 24, Article 172. [Google Scholar] [CrossRef] [PubMed]
[4] Fan, P.C., et al. (2018) ADVANCIS Score Predicts Acute Kidney Injury after Percutaneous Coronary Intervention for Acute Cor-onary SyndromeInternational Journal of Medical Sciences, 15, 528-535. [Google Scholar] [CrossRef] [PubMed]
[5] Kellum, J.A. and Lameire, N. (2013) Diagnosis, Evaluation, and Manage-ment of Acute Kidney Injury: A KDIGO Summary (Part 1). Critical Care, 17, Article No. 204. [Google Scholar] [CrossRef] [PubMed]
[6] Wang, C., et al. (2019) Risk Factors for Acute Kidney Injury in Patients with Acute Myocardial Infarction. Chinese Medical Journal, 132, 1660-1665. [Google Scholar] [CrossRef] 
[7] Frydman, S., et al. (2022) Relation of Gender to the Occur-rence of AKI in STEMI Patients. Journal of Clinical Medicine, 11, Article 6565. [Google Scholar] [CrossRef] [PubMed]
[8] Tsai, T.T., et al. (2014) Contemporary Incidence, Predictors, and Out-comes of Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Interventions: Insights from the NCDR Cath-PCI Registry. JACC: Cardiovascular Interventions, 7, 1-9.
[9] Almendarez, M., et al. (2019) Procedural Strate-gies to Reduce the Incidence of Contrast-Induced Acute Kidney Injury during Percutaneous Coronary Intervention. JACC: Cardiovascular Interventions, 12, 1877-1888. [Google Scholar] [CrossRef] [PubMed]
[10] Marenzi, G., Assanelli, E., Campodonico, J., De Metrio, M., Lauri, G., Marana, I., et al. (2010) Acute Kidney Injury in ST-Segment Elevation Acute Myocardial Infarction Complicated by Cardiogenic Shock at Admission. Critical Care Medicine, 38, 438-444. [Google Scholar] [CrossRef] 
[11] Brar, S.S., et al. (2014) Haemodynamic-Guided Fluid Ad-ministration for the Prevention of Contrast-Induced Acute Kidney Injury: The POSEIDON Randomised Controlled Trial. The Lancet, 383, 1814-1823. [Google Scholar] [CrossRef] 
[12] Moroni, F., et al. (2021) Tailored versus Standard Hydration to Prevent Acute Kidney Injury after Percutaneous Coronary Intervention: Network Meta-Analysis. Journal of the Amer-ican Heart Association, 10, e021342. [Google Scholar] [CrossRef] 
[13] Xu, R., et al. (2016) Effectiveness of N-Acetylcysteine for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of the American Heart Association, 5, e003968. [Google Scholar] [CrossRef] 
[14] Leoncini, M., et al. (2014) Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syn-drome: Results from the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy on Con-trast-Induced Acute Kidney Injury and Myocardial Damage in Patients with Acute Coronary Syndrome). Journal of the American College of Cardiology, 63, 71-79. [Google Scholar] [CrossRef] [PubMed]
[15] Göcze, I., et al. (2018) Biomarker-Guided Intervention to Prevent Acute Kidney Injury after Major Surgery. Annals of Surgery, 267, 1013-1020. [Google Scholar] [CrossRef] 
[16] Meersch, M., et al. (2017) Prevention of Cardiac Sur-gery-Associated AKI by Implementing the KDIGO Guidelines in High Risk Patients Identified by Biomarkers: The PrevAKI Randomized Controlled Trial. Intensive Care Medicine, 43, 1551-1561. [Google Scholar] [CrossRef] [PubMed]
[17] Kashani, K., et al. (2013) Discovery and Validation of Cell Cycle Arrest Biomarkers in Human Acute Kidney Injury. Critical Care, 17, Article No. R25. [Google Scholar] [CrossRef] [PubMed]
[18] Ostermann, M., et al. (2020) Recommendations on Acute Kidney Injury Bi-omarkers from the Acute Disease Quality Initiative Consensus Conference. JAMA Network Open, 3, e2019209. [Google Scholar] [CrossRef] [PubMed]
[19] Mehran, R., et al. (2004) A Simple Risk Score for Pre-diction of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention. Journal of the American College of Cardiology, 44, 1393-1399. [Google Scholar] [CrossRef] 
[20] Ma, K., et al. (2022) Development and Validation of a Risk Nomogram Model for Predicting Contrast-Induced Acute Kidney Injury in Patients with Non-ST-Elevation Acute Coro-nary Syndrome Undergoing Primary Percutaneous Coronary Intervention. Clinical Interventions in Aging, 17, 65-77. [Google Scholar] [CrossRef] 
[21] 张娟, 魏璐, 张宇, 裴小华, 柏云, 雍珍珠, 沈雪, 张群, 赵卫红. 肾小球滤过率增龄变化及其影响因素的研究[J]. 中华老年医学杂志, 2021, 40(10): 1250-1254.
[22] Mehran, R., Dangas, G.D. and Weisbord, S.D. (2019) Contrast-Associated Acute Kidney Injury. New England Journal of Medicine, 380, 2146-2155. [Google Scholar] [CrossRef] 
[23] Li, Q., Zhao, M. and Zhou, F. (2020) Hospi-tal-Acquired Acute Kidney Injury in Very Elderly Men: Clinical Characteristics and Short-Term Outcomes. Aging Clini-cal and Experimental Research, 32, 1121-1128. [Google Scholar] [CrossRef] [PubMed]
[24] 赵连友, 孙英贤, 李悦, 李玉明, 李妍, 蔡军, 谢良地, 陶军, 崔兆强, 郭艺芳, 陈晓平, 张国刚, 卢成志, 杨德业, 龙明智, 余静, 田刚, 王胜煌, 黄晶, 郑泽琪, 刘越, 李静, 叶涛. 经皮冠状动脉介入治疗术后血压管理中国专家共识[J]. 中华高血压杂志, 2022, 30(6): 506-513, 500. [Google Scholar] [CrossRef] 
[25] James, M.T., et al. (2015) A Meta-Analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension with Acute Kidney Injury. American Journal of Kidney Diseases, 66, 602-612. [Google Scholar] [CrossRef] [PubMed]
[26] Lun, Z., et al. (2021) Hypertension as a Risk Factor for Con-trast-Associated Acute Kidney Injury: A Meta-Analysis Including 2,830,338 Patients. Kidney and Blood Pressure Re-search, 46, 670-692. [Google Scholar] [CrossRef] [PubMed]
[27] 陈航, 刘童, 王浩. 低水平高密度脂蛋白胆固醇对冠心病PCI手术患者肾脏功能的影响[J]. 心血管康复医学杂志, 2015, 24(6): 627-629.
[28] 王林琳, 戴李华, 刘新兵. AMI早期血糖波动对造影剂相关急性肾损伤的影响[J]. 心血管康复医学杂志, 2021, 30(5): 521-525.
[29] Nam, K., et al. (2019) Intraoperative Glucose Variability, But Not Average Glucose Concentration, May Be a Risk Factor for Acute Kidney Injury after Cardiac Surgery: A Retrospective Study. Canadian Journal of Anesthesia, 66, 921-933. [Google Scholar] [CrossRef] [PubMed]
[30] Smith, L.E., et al. (2017) High-Density Lipoprotein Cholesterol Concentration and Acute Kidney Injury after Cardiac Surgery. Journal of the American Heart Association, 6, e006975. [Google Scholar] [CrossRef] 
[31] 高娜, 李静. 重症急性胰腺炎合并急性肾损伤的危险因素分析[J]. 临床消化病杂志, 2022, 34(3): 203-206.
[32] Xu, X., et al. (2017) Hyperuricemia Increases the Risk of Acute Kidney Injury: A Systematic Review and Meta-Analysis. BMC Nephrology, 18, Article No. 27. [Google Scholar] [CrossRef] [PubMed]
[33] Puti, E., et al. (2021) High Uric Acid Level Increases the Risk of Acute Kidney Injury in Acute Coronary Syndrome Patients. Caspian Journal of Internal Medicine, 12, 323-326.
[34] Li, S., et al. (2019) Hyperhomocysteinemia Accelerates Acute Kidney Injury to Chronic Kidney Disease Progression by Downregulating Heme Oxygenase-1 Expression. Antioxidants & Redox Signaling, 30, 1635-1650. [Google Scholar] [CrossRef] [PubMed]
[35] Barbieri, L., et al. (2015) Elevated Homocysteine and the Risk of Con-trast-Induced Nephropathy. Angiology, 66, 333-338. [Google Scholar] [CrossRef] [PubMed]
[36] 池东璇, 李楠, 周炜杰, 袁翠, 谢旻, 李卓, 汪润, 屈晨雪, 李雪迎, 李双玲, 杨莉, 王东信. 术后尿蛋白水平对非心脏手术危重症患者急性肾损伤的预测价值[J]. 中华医学杂志, 2022, 102(5): 336-343.
[37] Coca, S.G., et al. (2012) Pre-operative Proteinuria Predicts Acute Kidney Injury in Patients Undergoing Cardiac Surgery. The Journal of Thoracic and Cardiovascular Surgery, 143, 495-502. [Google Scholar] [CrossRef] [PubMed]
[38] Glassock, R.J. (2010) Is the Presence of Microalbuminuria a Relevant Marker of Kidney Disease? Current Hypertension Reports, 12, 364-368. [Google Scholar] [CrossRef] [PubMed]
[39] Perner, A., et al. (2017) Fluid Management in Acute Kidney Inju-ry. Intensive Care Medicine, 43, 807-815. [Google Scholar] [CrossRef] [PubMed]
[40] Zhou, L., et al. (2022) Loop Diuretics Are Associated with In-creased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study. Journal of Clinical Medicine, 11, Article 3665. [Google Scholar] [CrossRef] [PubMed]
[41] Dreischulte, T., et al. (2015) Combined Use of Nonsteroidal An-ti-Inflammatory Drugs with Diuretics and/or Renin-Angiotensin System Inhibitors in the Community Increases the Risk of Acute Kidney Injury. Kidney International, 88, 396-403. [Google Scholar] [CrossRef] [PubMed]
[42] 李嘉俊. 非甾体抗炎药致急性肾损伤的危险因素、发生机制、预防与治疗方法的研究分析[J]. 北方药学, 2017, 14(8): 184-185.
[43] Klomjit, N. and Ungprasert, P. (2022) Acute Kidney Injury Associated with Non-Steroidal An-ti-Inflammatory Drugs. European Journal of Internal Medicine, 101, 21-28. [Google Scholar] [CrossRef] [PubMed]
[44] 王聪, 裴源源, 朱继红. 急性ST段抬高性心肌梗死患者发生急性肾损伤的危险因素[J]. 中国急救医学, 2021, 41(6): 461-464.
[45] Ye, J., et al. (2023) Risk Factors Associated with Contrast-Associated Acute Kidney Injury in ST-Segment Elevation Myocardial Infarction Patients: A Systematic Review and Meta-Analysis. BMJ Open, 13, e070561. [Google Scholar] [CrossRef] [PubMed]
[46] 雷莹, 聂晟, 孙丹华, 宾伟, 徐欣. 中国危重症住院患者急性肾损伤的流行病学分析[J]. 南方医科大学学报, 2016, 36(6): 744-750.

为你推荐