急性肾衰竭220例临床和预后分析

Study of Relationship Between Clinical Characteristics and Prognosis of 220 Patients with Acute Renal Failure

【目的】总结急性肾功能衰竭(ARF)的病因、临床特征和预后的关系。【方法】对本院2000年1月至2003年12月220例ARF患者的临床资料进行回顾性分析。【结果】肾前性ARF为16.4%;单纯肾实质性ARF占56.8%,其中药物引起者占32.8%,病因以氨基糖甙类抗生素多见,碘造影剂占第2位;肾后性ARF高达26.8%。ARF患者病死率为11.4%,6.4%的病人放弃治疗,完全治愈率为40.9%,好转率为41.4%。单因素分析显示:年龄、蛋白尿、器官衰竭数目是影响预后的因素。【结论】小管间质病变和结石梗阻是ARF病人的主要病因,肾前性ARF病死率最高。早期诊断,预防多器官功能衰竭有助于提高ARF患者存活率。

[Objective]To analyze the relationship of clinical characteristics and prognosis in patients with acute renal failure（ARF）. [Methods]The data of 220 patients with ARF from January, 2000 to December, 2003 in our hospital were studied retrospectively. [Results]ARF patients with pre-renal causes were 16.4% ; single renal cortex and/or medullary disease leading to ARF were 56.8%, ARF induced by drugs was 32.8%, the main drugs were aminoglycosides, contrast media ; post-renal cause was 26.8%. The mortality rate was 11.4% ; 6.4% patients resigned treatment. The rates of cure and recovery were 40. 9% and 41.4% in patients with ARF respectively. Univariate analysis showed that prognosis was correlated with age, proteinuria and the number of organ system failures. [Conclusion]The main causes of the 220 patients with ARF are acute tubular interstitial injuries and obstruction （stone）. The mortality rate of patients with pre-renal ARF increases significantly. The early diagnosis and prevention of complication are key management to decrease mortality in severe ARF.