| 张宁,李博,陈蓉,等.脓毒症新生儿早期肾损伤的致病因素和风险评估[J].安徽医药,2022,26(8):1548-1551. |
| 脓毒症新生儿早期肾损伤的致病因素和风险评估 |
| Risk factors of early renal injury in neonates with sepsis |
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| DOI：10.3969/j.issn.1009-6469.2022.08.015 |
| 中文关键词: 脓毒症 新生儿 肾损伤 风险因素 |
| 英文关键词: Sepsis Newborn Renal injury Risk factors |
| 基金项目:山东省医药卫生科技发展计划项目(2018WS089) |
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| 中文摘要: |
| 目的分析早期脓毒症引起肾损伤发生的风险因素。方法选取2017年10月至2018年9月潍坊市妇幼保健院收住的确诊为脓毒症的新生儿61例，根据尿微量白蛋白升高与否分为肾小球损伤组21例和肾小球无损伤组40例。估算新生儿肾小球滤过率(eGFR)来评估肾损伤，并找出易引起肾损伤的风险因素。结果两组性别、胎龄、出生体质量、分娩方式及日龄等一般资料比较，差异无统计学意义(P>0.05)。出生时使用呼吸机、出现黄疸、合并新生儿呼吸窘迫综合征(NRDS)、凝血功能障碍、胎盘病理证实的绒毛膜羊膜炎、降钙素原(PCT)增高是新生儿脓毒症出现早期肾小球功能损伤的危险因素。进一步行lo?gistic回归分析，结果显示出生时出现黄疸［OR=10.86，95%CI(2.05，57.67)］、凝血功能障碍［OR=9.75，95%CI(1.66，57.40)］、PCT增高［OR=1.07，95%CI(1.02，1.13)］是脓毒症新生儿发生早期肾小球功能损伤的主要危险因素。结论脓毒症可导致新生儿不同程度的早期肾小球功能损害，出生时出现黄疸、凝血功能障碍及PCT增高是脓毒症新生儿发生早期肾小球功能损伤的主要危险因素。 |
| 英文摘要: |
| Objective To analyze the risk factors of renal injury caused by early sepsis.Methods Sixty-one cases of neonatal sep?sis in Weifang Maternal and Child Health Hospital from October 2017 to September 2018 were selected. According to the increase of urinary microalbumin, the neonatal sepsis group was divided into 21 cases of glomerular injury group and 40 cases of glomerular noninjury group. Glomerular filtration rate (eGFR) was used to evaluate renal injury and identify the risk factors of renal injury.Results There were no significant differences in gender, gestational age, birth weight, mode of delivery and age and other general information be?tween the two groups (P>0.05). Univariate analysis of the risk factors of neonatal glomerular injury in sepsis group showed that the use of ventilator, jaundice, neonatal respiratory distress syndrome (NRDS), coagulation dysfunction, chorioamnionitis confirmed by placen?tal pathology and increased procalcitonin (PCT) were the risk factors for early glomerular injury in neonatal sepsis. Further logistic re?gression analysis showed that jaundice at birth [OR=10.86,95%CI(2.05,57.67)], coagulation dysfunction [OR=9.75,95%CI(1.66,57.40)],increased PCT [OR=1.07,95%CI(1.02,1.13)] were the main risk factors of early glomerular dysfunction in sepsis newborns factor.Con?clusions Sepsis can lead to different degrees of early glomerular dysfunction in neonates.Jaundice, coagulation dysfunction and in?creased PCT at birth are the main risk factors for early glomerular dysfunction in neonates with sepsis. |
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