目的 探讨主动脉夹层术后急性肾损伤（AKI）的危险因素，并分析AKI与血管活性药的相关性。方法 选择2020年10月—2022年3月期间，华中科技大学同济医学院附属同济医院收治的334例急性A型主动脉夹层患者的临床资料，其中272例符合纳入标准。根据术后是否发生AKI，分为AKI组（223例）和非AKI组（49例），对患者术后发生AKI的影响因素进行多因素Logistic回归分析；同时根据给予血管活性药的不同将其分为单药组（单用多巴胺）98例和多药组（多巴胺及肾上腺素和/或去甲肾上腺素和/或多巴酚丁胺的2种或3种组合）174例，比较两组术后AKI的发生率。结果 AKI组年龄、体外循环时长、术后TnI水平、BMI高于非AKI组（P＜0.05）。年龄、肥胖、2种以上血管活性药、术后TnI是主动脉夹层术后AKI的独立危险因素（P＜0.05）。单药组术后AKI发生率低于多药组（P＜0.05）。结论 年龄、肥胖、2种以上血管活性药、术后TnI是主动脉夹层术后AKI的独立危险因素，在使用2种以上血管活性药物时，需加强对术后发生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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