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低剂量氟比洛芬酯可降低术后急性肾损伤发生率:9915例回顾性临床数据分析

Low dose of flurbiprofen axetil decrease the rate of acute kidney injury after operation: a retrospective clinical data analysis of 9915 cases.

作者信息

Wang Dong, Yang Shi-Kun, Zhao Meng-Xi, Tang Yong-Zhong, Ou-Yang Wen, Zhang Hao, Liao Qin

机构信息

Department of Anesthesiology, The Third Xiangya Hospital of Central South University, 138, Tongzipo Road, Changsha, Hunan, China.

Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.

出版信息

BMC Nephrol. 2020 Feb 14;21(1):52. doi: 10.1186/s12882-020-1711-5.

Abstract

BACKGROUND

Flurbiprofen axetil (FA) is a commonly prescribed agent to relieve perioperative pain, but the relationship between FA and postoperative acute kidney injury (AKI) remains unclear. This study attempted to evaluate the effects of different dose of perioperative FA on postoperative AKI.

METHODS

A total of 9915 patients were enrolled for this retrospective study. The clinical characteristics and the prevalence of postoperative AKI among patients non-using, using low dose (50-100 mg), middle dose (100-250 mg) and large dose (≧250 mg) of FA were analyzed respectively. The impact of different dose of FA on postoperative AKI was analyzed using univariable and multivariate logistic regression analysis.

RESULTS

The prevalence of postoperative AKI was 6.7% in the overall subjects and 5.1% in 2446 cases who used FA. The incidence of AKI in low dose group was significantly less than that of non use group (4.5% vs 7.2%, P < 0.001), but the incidence of AKI in large dose group was significantly higher than that in the non-use group (18.8% vs 7.2%, P < 0.001). However, there was no significant difference between patients without using FA and subjects using middle dose of FA (7.2% vs 5.6%, p = 0.355). Multivariate logistic regression analysis showed that low dose of FA was a protective factor for postoperative AKI (OR = 0.75, p = 0.0188), and large dose of FA was a risk factor for postoperative AKI (OR = 4.8, p < 0.0001).

CONCLUSIONS

The impact of FA on postoperative AKI was dose-dependent, using of low dose FA (50-100 mg) perioperatively may effectively reduce the incidence of postoperative AKI.

摘要

背景

氟比洛芬酯(FA)是一种常用于缓解围手术期疼痛的药物,但FA与术后急性肾损伤(AKI)之间的关系仍不明确。本研究旨在评估围手术期不同剂量的FA对术后AKI的影响。

方法

本回顾性研究共纳入9915例患者。分别分析了未使用FA、使用低剂量(50 - 100毫克)、中剂量(100 - 250毫克)和高剂量(≥250毫克)FA患者的临床特征及术后AKI的患病率。采用单因素和多因素逻辑回归分析不同剂量FA对术后AKI的影响。

结果

总体研究对象中术后AKI的患病率为6.7%,在2446例使用FA的患者中为5.1%。低剂量组AKI的发生率显著低于未使用组(4.5%对7.2%,P < 0.001),但高剂量组AKI的发生率显著高于未使用组(18.8%对7.2%,P < 0.001)。然而,未使用FA的患者与使用中剂量FA的患者之间无显著差异(7.2%对5.6%,p = 0.355)。多因素逻辑回归分析显示,低剂量FA是术后AKI的保护因素(OR = 0.75,p = 0.0188),高剂量FA是术后AKI的危险因素(OR = 4.8,p < 0.0001)。

结论

FA对术后AKI的影响呈剂量依赖性,围手术期使用低剂量FA(50 - 100毫克)可能有效降低术后AKI的发生率。

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