Kitagawa M
Nihon Geka Gakkai Zasshi. 1987 Feb;88(2):163-75.
Effect of cardiac function on postoperative renal function was studied in 54 cases. These cases were divided into two groups according to postoperative cardiac function. Group A was good cardiac function group (27 cases; the value of C.I. was below 2.2L/min/m2 less than once through all examinations after operation). Group B was low cardiac function group (27 cases; the value of C.I. was below 2.2L/min/m2 more than twice through all examinations after operation). Significant differences were found in cardiac index, mean arterial pressure, left, arterial pressure and total vascular resistance in two groups. Significant differences were not found in urinary volume and FENa in two groups. In creatinine clearance and free water clearance significant differences were found from early postoperative period, and group A showed better renal function than group B. Serum Na, serum K and urinary Na:K ratio were not significantly different between two groups. Difference of plasma renin activity was not significant, but plasma aldosterone was significantly higher in group B than in group A during postoperative period. In group B, four patients developed nonoliguric acute renal failure, eventually resulting in MOF. The author concluded that postoperative cardiac function played the most important role on the state of postoperative renal function.
对54例患者研究了心功能对术后肾功能的影响。根据术后心功能将这些病例分为两组。A组为心功能良好组(27例;心脏指数值低于2.2L/(min·m²),术后所有检查中低于此值的情况少于1次)。B组为心功能低下组(27例;心脏指数值低于2.2L/(min·m²),术后所有检查中低于此值的情况多于2次)。两组在心脏指数、平均动脉压、左动脉压和总血管阻力方面存在显著差异。两组在尿量和滤过钠排泄分数方面未发现显著差异。在肌酐清除率和自由水清除率方面,术后早期即发现显著差异,且A组肾功能优于B组。两组血清钠、血清钾和尿钠钾比值无显著差异。血浆肾素活性差异不显著,但术后B组血浆醛固酮显著高于A组。B组有4例患者发生非少尿型急性肾衰竭,最终导致多器官功能衰竭。作者得出结论,术后心功能对术后肾功能状态起最重要作用。