| 苗林,吴翔,吴竹斌,等.急性肾损伤连续性肾脏替代治疗后肾功能恢复的影响因素[J].安徽医药,2019,23(10):1991-1994. |
| 急性肾损伤连续性肾脏替代治疗后肾功能恢复的影响因素 |
| The risk factors of renal function recovery with continuous renal replacement therapy in acute kidney injury patients |
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| DOI：10.3969/j.issn.1009?6469.2019.10.021 |
| 中文关键词: 急性肾损伤 感染 休克 血尿素氮 肾小球滤过率 血小板计数 血红蛋白类 血清白蛋白 连续性肾脏替代治疗 肾功能恢复 影响因素 |
| 英文关键词: Acute kidney injury Infection Shock Blood urea nitrogen Glomerular filtration rate Platelet count Hemoglobins Serum albumin CRRT treatment Renal function recovery Influencing factors |
| 基金项目:安徽省高校自然科学研究重点项目(KJ2018A0247) |
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| 中文摘要: |
| 目的分析急性肾损伤( AKI)病人经连续性肾脏替代治疗( CRRT)后肾功能恢复的影响因素。方法选取皖南医学院第二附属医院 2013年 1月至 2017年 12月收治的 50例接受 CRRT治疗的 AKI病人为研究对象，依据肾功能是否恢复分为肾功能恢复组和肾功能未恢复组。采用系统性回顾法分析 AKI的病因，多因素 logistic回归分析法对数据进行对比、分析，探讨 CRRT与肾功能恢复的关系。结果在导致 AKI的病因中，主要是感染 56%(28/50)和休克 30%(15/50)。 AKI病人经 CRRT治疗后，肾功能恢复组的急性生理学与慢性健康状况评分系统 Ⅱ(APACHEⅡ)评分［(21.86±4.57)分比( 28.82±5.69)分］、器官衰竭数目［(2.91±0.75)个比( 4.21±1.82)个］、有严重基础性疾病比率( 22.73%比 67.86%)、机械通气比率、血管活性药物应用比率、少或无尿比率、有慢性肾脏病比率、血白细胞计数均少于肾功能未恢复组，血小板计数、血红蛋白浓度、血清白蛋白浓度及 CRRT介入时期更早的比率［(22.73%，50.00%，27.27%)(3.57%，32.14%，64.28%)］均大于肾功能未恢复组，均差异有统计学意义( P＜0.05)。 logistic回归分析结果提示， APACHEⅡ评比分( OR＝1.464，95%CI:1.227~2.988)、器官衰竭数目( OR＝2.351， 95%CI:1.688~3.291)、有严重基础性疾病( OR＝3.373，95%CI:2.320~9.931)及 CRRT治疗介入时期( OR＝3.373，95%CI:1.981~ 8.377)为 AKI病人经 CRRT治疗后肾功能恢复的影响因素。结论感染是 AKI的主要病因，而 APACHEⅡ评分、器官衰竭数目、有严重基础性疾病及 CRRT治疗介入时期等多种因素共同影响着肾功能的恢复。 |
| 英文摘要: |
| Objective To analyze the influencing factors of renal function recovery in patients with acute kidney injury(AKI)with continuous renal replacement therapy(CRRT).Methods A total of 50 patients with AKI who treated with CRRT in The SecondAffiliated Hospital of Wannan Medical College from January 2013 to December 2017 were enrolled in the study.The patients wereassigned into two groups: renal function recovery group and unrestored renal function group，according to whether renal functionwas restored.The etiology of AKI was analyzed by systematic review.The data were compared and analyzed by multi?factor logisticregression analysis to explore the relationship between CRRT with renal function recovery.Results The infections and shock were major cause of AKI，which were 56%(28/50)and 30%(15/50)respectively.AKI patients were treated with CRRT，APACHE II score［(21.86±4.57)vs.(28.82±5.69)］，number of organ failure［(2，.91±0.75)vs.(4.21±1.82)］，mechanical ventilation ratio，vaso? active drug application ratio，less or no urine ratio，proportion of chronic kidney disease，proportion of severe basic diseases |
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