持续肾替代治疗对脓毒症合并急性肾损伤患者肾功能及预后的影响

Effects of continuous renal replacement therapy for the prognosis and renal functions in sepsis patients with acute kidney injury

目的比较持续肾替代治疗(CRRT)对脓毒症合并不同程度急性肾损伤(AKI)患者肾功能及预后的影响。方法按AKI分期标准将脓毒症合并AKI患者分为A(AKI-Ⅰ期组)、B(AKI-Ⅱ期组)、C(AKI-Ⅲ期组)三组,比较三组患者CRRT后肾功能恢复及患者死亡率。结果A组CRRT后87.5%(14/16)患者肾损害平稳恢复,2例加重进入B组,但无死亡;B组CRRT后62.5%(20/32)患者肾损害稳定恢复,12例肾损害加重进入C组,死亡率18.7%(6/32);C组CRRT后30.4%(14/46)肾损害逐渐恢复,32例加重进入ARF期,其中18例死亡,死亡率39.1%(18/46)。A、C及B、C组间差异有统计学意义(P<0.01)。结论脓毒症合并AKI患者早期行CRRT有可能阻止肾损害加重并明显改善预后。

Objective To explore the effects of Continuous Renal Replacement Therapy （CRRT） on the prognosis and renal functions in different level of acute kidney injury （AKI） for sepsis patients. Methods According to AKI criteria, patients were divided into three groups： A （AKI - Ⅰ group）, B （AKI -Ⅱgroup） and C （AKI -Ⅲ group）. And mortality and renal function progress were compared. Results Renal function remission rate among group A, B and C were respectively 87.5%, 62.5% and 30.4%. No patient died in group A, mortality in group B and C were respectively 18.7%, 39.1%. Comparing with group C, there were significant statistic difference among group A and B for renal functions remission and mortality. Conclusion Early CRRT treatment for sepsis patients with AKI may help renal functions remission and improve their prognosis.