临床荟萃

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86例急性肾损伤患者的临床特征及分析

  

  1. 安徽省立医院 肾内科,安徽 合肥  230001
  • 出版日期:2018-02-05 发布日期:2018-02-11
  • 通讯作者: 通信作者:胡志伟,Email: yijianfenghong@sina.com

Clinical features and analysis of 86 patients with acute kidney injury

  1. Department of Nephrology,  Anhui Provincial Hospital,  Hefei  230001,  China
  • Online:2018-02-05 Published:2018-02-11
  • Contact: Corresponding author:Hu Zhiwei, Email: yijianfenghong@sina.com

摘要: 目的  探讨急性肾损伤(AKI)的病因、临床特点及预后。方法  回顾性分析我院86例AKI患者的临床特点。将其分为恢复组(包括肾功能完全恢复及部分恢复)及未恢复组(包括死亡、自动出院及长期透析),两组年龄、性别、血红蛋白、血白蛋白、血尿酸、基础病(高血压、糖尿病、冠心病等)、少尿发生率、透析率等方面进行分析,并分析患者预后不良的危险因素。结果  86例患者中死亡4例(4.65%),自动出院13例(15.12%),长期透析2例(2.33%),好转67例(77.90%),病因主要包括:肾前性灌注不足、感染、肾后性梗阻、心功能不全、药物等,其中以肾前性灌注不足及感染为主要原因。两组年龄、性别、血红蛋白、血白蛋白、基础病、透析率方面差异均无统计学意义(P>0.01),未恢复组血尿酸水平及少尿发生率高于恢复组(P<0.05)。少尿是AKI患者预后不良的独立危险因素。结论  AKI临床发病率及病死率高,肾前性灌注不足及感染是引起AKI的重要原因;少尿是AKI患者预后不良的独立危险因素。

关键词: 急性肾损伤, 少尿, 透析

Abstract: Objective  To investigate the etiology, clinical features and prognosis of acute renal injury(AKI). Methods  The clinical characteristics of 86 patients with AKI  were analyzed retrospectively.They were divided into the recovery group (including renal function recovered completely and partially restored) and the nonrecovery group (including death, automatic discharge and longterm dialysis).  The age, gender, hemoglobin, serum albumin, serum uric acid, basic diseases (hypertension, diabetes, coronary heart disease), dialysis rate and rate of oliguria were statistically analyzed.  Additionally,the risk factors of poor prognosis were analyzed. Results  Of  86 patients, 4 patients died (4.65%), 13 patients were discharged automatically (15.12%), 2 patients received longterm dialysis(2.33%), and 67 patients improved (77.90%), the main causes of the disease included insufficient anterior renal perfusion, infection, postrenal obstruction, cardiac insufficiency, drugs and so on, among which renal insufficiency and infection were the main causes. There were no significant differences in age, gender, hemoglobin, serum albumin, basic disease, dialysis rate between two groups (P>0.05). The blood uric acid level and oliguria incidence in nonrecovery group were significantly higher than those in the recovery group (P<0.05). Multiple logistic regression analysis showed that oliguria was an independent risk factor for poor prognosis in patients with AKI. Conclusion  AKI patients have high clinical morbidity and mortality, early diagnosis and active intervention can improve the clinical prognosis; prerenal hypoperfusion and infection; oliguria is an independent risk factor of poor prognosis of patients with AKI.

Key words: acute kidney injury, oliguria, dialysis