目的 探討主動(dòng)脈夾層術(shù)后急性腎損傷（AKI）的危險(xiǎn)因素，并分析AKI與血管活性藥的相關(guān)性。方法 選擇2020年10月—2022年3月期間，華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院收治的334例急性A型主動(dòng)脈夾層患者的臨床資料，其中272例符合納入標(biāo)準(zhǔn)。根據(jù)術(shù)后是否發(fā)生AKI，分為AKI組（223例）和非AKI組（49例），對(duì)患者術(shù)后發(fā)生AKI的影響因素進(jìn)行多因素Logistic回歸分析；同時(shí)根據(jù)給予血管活性藥的不同將其分為單藥組（單用多巴胺）98例和多藥組（多巴胺及腎上腺素和/或去甲腎上腺素和/或多巴酚丁胺的2種或3種組合）174例，比較兩組術(shù)后AKI的發(fā)生率。結(jié)果 AKI組年齡、體外循環(huán)時(shí)長(zhǎng)、術(shù)后TnI水平、BMI高于非AKI組（P＜0.05）。年齡、肥胖、2種以上血管活性藥、術(shù)后TnI是主動(dòng)脈夾層術(shù)后AKI的獨(dú)立危險(xiǎn)因素（P＜0.05）。單藥組術(shù)后AKI發(fā)生率低于多藥組（P＜0.05）。結(jié)論 年齡、肥胖、2種以上血管活性藥、術(shù)后TnI是主動(dòng)脈夾層術(shù)后AKI的獨(dú)立危險(xiǎn)因素，在使用2種以上血管活性藥物時(shí)，需加強(qiáng)對(duì)術(shù)后發(fā)生AKI的防治工作。

Objective To investigate the risk factors of acute kidney injury (AKI) after aortic dissection surgery and analyze the cor‐ relation between AKI and vasoactive drugs. Methods The clinical data of 334 patients with acute type A aortic dissection admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2020 to March 2022 were selected, and 272 patients met the inclusion criteria. According to whether AKI occurred after surgery, the patients were divided into AKI group (n = 223) and non-AKI group (n = 49), and the influencing factors of postoperative AKI were analyzed by multivari‐ ate Logistic regression analysis. At the same time, according to the different vasoactive drugs given, the patients were divided into single drug group (dopamine alone, n = 98) and multi-drug group (dopamine and epinephrine and/or norepinephrine and/or dobuta‐ mine in two or three combinations, n = 174), and the incidence of postoperative AKI was compared between the two groups. Results Age, cardiopulmonary bypass time, postoperative TnI level, and BMI in the AKI group were higher than those in the non-AKI group (P < 0.05). Age, obesity, more than two kinds of vasoactive drugs, and postoperative TnI were independent risk factors for AKI after aortic dissection surgery (P < 0.05). The incidence of postoperative AKI in the single drug group was lower than that in the multidrug group (P < 0.05). Conclusion Age, obesity, more than two kinds of vasoactive drugs, postoperative TnI are independent risk factors for AKI after aortic dissection surgery. When using more than two kinds of vasoactive drugs, the prevention and treatment of postoperative AKI should be strengthened.

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