尿路结石相关梗阻型急性肾盂肾炎脓毒症的危险因素分析

Analysis of Risk Factors for Urinary Calculi Associated with Obstructive Acute Pyelonephritis Sepsis

目的探讨尿路结石相关梗阻型急性肾盂肾炎脓毒症的相关危险因素。方法选择2007年1月-2012年12月来我院接受治疗的脓毒症患者80例。根据患者临床特征分为非尿路结石相关梗阻型急性肾盂肾炎脓毒症组(A组,n=40)和尿路结石相关梗阻型急性肾盂肾炎脓毒症组(B组,n=40)。详细记录患者的一般情况和实验室检查结果,应用单因素、多因素非条件Logistic回归分析进行尿路结石相关梗阻型急性肾盂肾炎脓毒症的危险因素分析。结果80例脓毒症患者临床特征显示,B组在MAP评分、SOFA评分、APACHE II评分、SAPS评分、SCr评分、动脉血乳酸评分、24h液体净人量评分、血BUN、心率、PCT方面显著高于A组(P<0.05),在24h尿量、氧合指数、白蛋白、血小板、血钠方面显著低于A组(P<0.05)。高MAP评分、高SAPS评分、高SCr评分、高动脉血乳酸评分、高24h液体净人量评分、心率加快、血小板减少、低血钠水平会增加尿路结石相关梗阻型急性肾盂肾炎脓毒症发生的风险(P<0.05)。结论临床医师在诊治尿路结石相关梗阻型急性肾盂肾炎脓毒症过程中,更应关注患者的MAP评分、SAPS评分、SCr评分、动脉血乳酸评分、24h液体净人量评分、心率、血小板及血钠水平。

Objective To explore the risk of urinary calculi associated with obstructive acute pyelonephritis sepsis factors.Methods 80 cases of sepsis patients receiving treatment in our hospital between 2007.1 and 2012.12 were collected and reviewed.According to the clinical characteristics of patients were divided into non-obstructive urinary calculi associated with acute pyelonephritis sepsis group（A group,n=40）and urinary calculi associated obstructive acute pyelonephritis sepsis group（group B,n=40）.The general situation of patients and the results of laboratory tests were recorded in detail.Non conditional Logistic regression analysis of risk factors for urinary calculi associated with obstructive acute pyelonephritis sepsis by single and multiple factors.Results 80 cases of sepsis in patients with clinical features,B group in the MAP score,SOFA score,APACHE II score,SAPS score,SCr score,blood lactate score,24 hliquid net score,heart rate,blood BUN,PCT were significantly higher than that of A group（P〈0.05）,24 hin urine,oxygenation index,albumin,platelet,blood sodium were significantly lower than A group（P〈0.05）.The high MAP score,high SAPS score,high SCr score,high score,high arterial blood lactate 24 hliquid net score,heart rate,thrombocytopenia,low blood sodium levels could increase the risk of urinary calculi associated with obstructive acute pyelonephritis sepsis（P〈0.05）.Conclusion Clinicians in the diagnosis and treatment of urinary calculi associate with obstructive acute pyelonephritis during sepsis,more attention should be given to patients with MAP score,SAPS score,SCr score,blood lactate score,24 hnet amount of liquid score,heart rate,blood platelet and blood sodium level.