高血压脑出血发生急性肾损伤的危险因素研究

Analysis of risk factors of acute kidney injury after hypertensive cerebral hemorrhage

目的 探讨高血压脑出血发生急性肾损伤（AKI）的危险因素。方法 回顾性分析2013年8月～2015年8月在我院神经外科收治的脑出血患者。采用Logistic回归分析高血压脑出血患者发生AKI的危险因素。结果 共入选符合标准的高血压脑出血患者133例,其中AKI组占23.3%（31/133）,非AKI组占76.7%（102/133）。多因素回归分析显示,高血压病程≥10年（OR 2.385,95%CI 1.122～1.621,P〈0.001）、贫血（OR 2.211,95%CI 1.754～2.551,P=0.022）和使用甘露醇（OR 1.513,95%CI 1.925～3.312,P〈0.001）是AKI发生的独立危险因素。结论 AKI是高血压脑出血常见的并发症,高血压病程长、贫血和使用甘露醇是高血压脑出血患者发生AKI的独立危险因素。

Objective To investigate the incidence and risk factors of acute kidney injury （AKI） after hypertensive cere- bral hemorrhage. Methods Hypertensive cerebral hemorrhage patients who were admitted to Neurosurgical department from August 2013 to August 2015 were reviewed retrospectively. Logistic regression analysis was used to evaluate pos- sible risk factors associated with hypertensive cerebral hemorrhage AKI. Results A total of selected 133 patients were enrolled in the study including 23.3% （31/133） patients in AKI group and 76.7% （102/133） patients without AKI group. Multivariate Logistic regression analysis showed that hypertension duration≥ 10 years（OR2.385,95%CI 1.122~ 1.621 ,P〈0.001）, anemia（OR2.211,95%CI 1.754-2.551 ,P=0.022） and usage of mannitol（OR 1.513,95%CI 1.925-3.312, P〈0.001 ） were independent risk factors of AKI. Conclusion AKI is a common complication after hypertensive cerebral hemorrhage. Hypertension long duration, anemia, usage of mannitol are the independent risk factors of AKI in patients after hypertensive cerebral hemorrhage.