神经重症患者高钠血症与急性肾损伤的相关性研究

Correlation between hypernatremia and acute kidney injury in patients with critically neuralill

目的分析神经重症患者高钠血症与急性肾损伤的相关性。方法选择2014年1月~2016年12月在我院接受治疗的神经重症患者55例作为研究对象进行回顾性分析,按照是否发生急性肾损伤(AKI)分成观察组25例(AKI组)及对照组30例(非AKI组),统计两组临床资料,分析AKI发病影响因素。结果观察组入ICU后,各时间点血钠水平与对照组相比明显增高,差异显著(入ICU后0、1、2、3d的t值分别为8.2422、6.5485、7.0650、15.0142,P均<0.05);观察组入ICU后3d内出现高钠血症比例48.00%(12/25)与对照组的16.67%(5/30)相比增高明显,差异有统计学意义(χ~2=9.0642,P<0.05);经回归分析显示,与AKI关系密切的影响因素主要包括患者年龄、颅脑手术、甘露醇使用情况以及呼吸机机械通气时间、发生高钠血症情况,差异有统计学意义(P<0.05)。结论高钠血症与急性肾损伤之间关联比较密切,预防神经重症患者发生高钠血症有助于急性肾损伤的预防。

Objective To analyze the correlation between hypernatremia and acute kidney injury in critically neural ill patients. Methods A total of 55 patients with severe neurological diseases treated in our hospital from January 2014 to December 2016 were selected as the subjects. According to the occurrence of acute kidney injury （AKI）, they were divided into observation group 25 cases （group AKI） and control group 30 cases （non AKI group）. The clinical data of two groups were statistically analyzed, and the influencing factors of AKI were analyzed. Results The blood sodium level of the observation group after ICU was significantly higher than that of the control group, and the difference was significant （the T values of 0,1,2,3d after ICU were 8.2422,6.5485,7.0650,15.0142,P 〈0.05）;The proportion of hypernatremia in the observation group within 3D after ICU was 48% （12/25）, which was significantly higher than that of 16.67% （5/30） in the control group, and the difference was statistically significant（χ2=9.0642, P〈0.05）.The regression analysis was showed that the factors closely were related to AKI included age of patients, craniocerebral surgery, mannitol use, mechanical ventilation time, and hypernatremia, and the difference was significant （P 〈0.05）. Conclusion There is a close correlation between hypernatremia and acute kidney injury, and prevention of hypernatremia in critically ill patients is helpful for the prevention of acute kidney injury.