不同年龄慢性肾病患者发生急性肾损伤相关因素及临床治疗效果比较

Analysis of the risk factors of chronic kidney disease complicated with acute kidney injury

目的 比较青年人及老年人慢性肾脏病并发急性肾损伤相关因素及临床疗效.方法 180例慢性肾脏病并发急性肾损伤患者选为研究对象,其中老年组和中青年组各90例,比较两组基础疾病、急性肾损伤相关危险因素及临床疗效的不同.结果 老年组糖尿病肾病及高血压肾病的比例分别为31.1％和24.4％,显著高于中青年组的6.7％和4.4％;中青年组慢性肾小球肾炎、肾病综合征及狼疮肾炎的比例分别为37.8％、15.6％和20.0％,均显著高于老年组的17.8％、8.9％和2.2％（均P＜0.05）.老年组感染及肾毒性药物的比例分别为28.9％和22.2％,显著高于中青年组的11.1％和6.7％;中青年组恶性高血压及原发病恶化的比例分别为22.2％和26.7％,均显著高于老年组的4.4％和4.4％（均P＜0.05）.中青年组治疗有效率为88.9％,显著高于老年组的71.1％（x2=6.846,P＜0.05）.结论 老年与中青年慢性肾脏病并发急性肾损伤患者在基础疾病、危险因素及临床疗效方面存在显著差异.

Objective To analyze the risk factors of chronic kidney disease complicated with acute kidney injury and its treatment efficacy. Methods 180 chronic kidney disease patients complicated with acute kidney injury were divided into the elderly group and the young group. The underlying diseases, risk factors of acute kidney injury and clinical efficacy were compared between the two groups. Results The proportions of chronic glomerulonephritis, nephrotic syndrome and lupus nephritis in young and middle-aged group were 37.8% , 15.6% and 20.0% , which were significantly higher than those in the elderly group （ 17.8%, 8.9% ,2.2% ） （ P 〈 0.05 ）. The proportions of dia- betic nephropathy and hypertensive renal injury in elderly patients were 31.1% and 24.4% , which were significantly higher than those in the young and middle-aged group （6.7% ,4.4% ） （ P 〈 0.05 ）. In the old age group, the propor- tions of infections and renal toxicity drugs were 28.9% and 22.2% , which were significantly higher than those in the young group. In the young and middle-aged group, the proportions of malignant hypertension and deterioration of the primary disease were 22.2% and 26.7% , which were significantly higher than those in the elderly group （P 〈 0. 05 ）. The total effective rate of the young group was 88.9%, which was significantly higher than 71.1% of the eld- erly group （ X2 = 6. 846,P 〈 0.05 ）. Conclusion Elderly and young and middle-aged chronic kidney disease patients complicated with acute kidney injury have differences in risk factors and clinical efficacy.