老年急性肾损伤56例临床特点分析

Clinical features of acute kidney injury in 56 elderly patients

目的探讨老年人发生急性肾损伤（AKI）的病因、临床特点、合并症及影响预后的因素。方法对2004年1月至2009年1月在院内发生AKI患者的临床资料进行回顾性分析，并对相关因素进行探讨。结果老年人AKI发病率、病死率随年龄增长而增加。61～70岁、71～80岁、80岁以上的患病总人数分别是12、25、19，死亡人数分别是2、6、7，三者之间差异具有统计学意义。诱发AKI的最常见因素是严重感染（48．2％）、大手术及介入治疗（17．9％）、心源性疾病（14．3％）。药物引起的以氨基糖甙类为主。少尿是最重要的临床表现（76．7％）。治疗最有效的方法仍是肾脏替代治疗（67．5％）。结论老年人AKI以严重感染、大手术、心源性疾病为常见诱因，其发病率及死亡率较青年人高。肾脏替代治疗是影响预后的关键因素。

Objective To discuss etiology, clinical features, complications and factors influencing prognosis of acute kidney injury （AKI）in elderly patients. Method The clinical data of the patients with AKI were retrospectively analyzed in our hospital between January, 2004 and January, 2009. Result The morbidity and mortality of AKI in the elderly patients were increased with age. The respective total number of three groups of 61-70,71-80, and over 80 years old was 12,25, and 19, and the deaths were 2,6, and 7 （P〈0.05）. The most common factors inducing AKI included severe infection, major operation and cardiac disease. Aminoglycoside was the main drug causing AKI. Renal replacement therapy still was the most effective treatment. Conclusion In elderly patients, the most common factors inducing AKI were severe infection,major operation and cardiac disease. And the morbidity and mortality was relatively higher than that in young people. Renal replacement therapy was a key factor influencing prognosis.