儿童急性肾损伤62例临床分析

Clinical analysis of 62 cases of acute kidney injury

目的总结儿童急性肾损伤（AKI）的临床特点。方法回顾性分析2008年1月-12月收治的62例AKI住院患儿的临床资料。结果62例AKI患儿中男43例，女19例；城市6例，农村56例；平均年龄4.4岁。肾前性14例（22.6％），肾性30例（48.4％），肾后性18例（29.0％）；病因在各年龄组分布有统计学差异，新生儿期为肾前性因素，婴儿期主要为肾后性因素，其余年龄段主要为肾性因素。62例中治愈26例（41.9％），好转21例（33.9％），无效放弃14例（22.6％），死亡1例（1.6％）。少尿、血尿、蛋白尿、GRF等参数在各组间无统计学差异。单因素分析显示年龄、发病天数、是否出现少尿或血尿、血红蛋白、AKl分期是影响预后的因素。结论儿童AKI的病因多样化，其预后与发病年龄、原发病因及治疗时机有关；早期诊断有助于AKI的治疗，积极有效的治疗有助于提高存活率；需要重视儿童AKI的诊治。

Objective To analyze the clinical characteristics of 62 cases of acute kidney injury （AKI）. Methods The clinical data of 62 children with AKI in our hospital from January to December 2008 were retrospectively analyzed. Results There were 43 boys and 19 girls with mean age of 4.4 years old. The patterns of AKI included pre-renal （14, 22.6%）, renal parenehymal （30, 48.4 %） and post renal AKI （18, 29.0%）. There was significant difference in etiology among different age groups. The mortality of AKI in our study was 1.6%. There was no difference in oliguria, hematuria, proteinuria or GRF a-mong the 6 groups. Univariate analysis revealed that prognosis was correlated with age course of the disease, oliguria, hematuria, hemoglobin, and AKI degree. Conclusion The etiology of AKI in children is diverse, the prognosis is corrected with age, pathogenesis and treatment. The early diagnosis and effective treatment plays an important role in increasing survival rate. We should pay attention to the diagnosis and treatment of AKI in children.