Objective To investigate the influencing factors of postoperative acute kidney injury (AKI) in patients with acute Stanford Type A aortic dissection (TAAD), and to analyze the predictive value of preoperative neutrophil gelatinase-associated lipid transporter (NGAL) combined with serum β2-microglobulin (β2-MG) and myoglobin (Mb) in postoperative AKI. Methods 100 patients with TAAD who were treated in our hospital from January 2019 to January 2022 selected, and they were divided into AKI group (38 cases) and non-AKI group (62 cases) according to the occurrence of postoperative AKI. Preoperative urinary NGAL and serum β2-MG, Mb levels were detected and compared between the two groups. The influencing factors of the occurrence of postoperative AKI in patients with TAAD were analyzed, and the predictive value of preoperative urinary NGAL combined with serum β2-MG and Mb for the occurrence of postoperative AKI in patients with TAAD was analyzed. Results The preoperative urinary NGAL, serum β2-MG and Mb levels in AKI group were higher than those in non-AKI group (P<0.05). Body mass index (BMI), renal artery involvement ratio, intraoperative urine volume, intraoperative blood transfusion volume, preoperative serum creatinine (Scr) levels in AKI group were higher than those in non-AKI group, and the time of cardiopulmonary bypass and deep low temperature cycle stop time were longer than those in non-AKI group, and the age was longer than that in non-AKI group (P<0.05). Multivariate Logistic regression analysis showed that renal artery involvement, long time of cardiopulmonary bypass, preoperative Scr, urinary NGAL, high levels of serum β2-MG and Mb were the risk factors for the occurrence of postoperative AKI in patients with TAAD (P<0.05). The area under curve of preoperative urine NGAL combined with serum β2-MG and Mb for predicting the occurrence of postoperative AKI in patients with TAAD was 0.847, which was significantly higher than 0.689, 0.678 and 0.677 of the three indicators alone (P<0.05). Conclusion High preoperative urinary NGAL, serum β2-MG and Mb levels, renal artery involvement, and long time of cardiopulmonary bypass are risk factors for the occurrence of postoperative AKI in patients with TAAD. Combined detection of preoperative urinary NGAL, serum β2-MG and Mb levels has certain predictive value for the occurrence of postoperative AKI. |