206例急性肾损伤患者临床特点及预后分析

The Clinical Characteristics and Prognostic Factors of Patients with Acute Kidney Injury

目的:探讨急性肾损伤(AKI)患者的临床特点,寻找与预后相关的因素,为AKI临床治疗提供依据。方法:回顾性分析AKI患者人口统计学资料、病因、血清学指标、临床治疗等情况。按出院时肾功能状态分为恢复组和未恢复组,分析AKI预后的相关因素。结果:共有206例AKI患者纳入研究,男女比例为2.03∶1,平均年龄为(55.53±21.19)岁。血容量不足、感染是引起AKI最常见的病因,老年人是AKI高危人群。AKIⅠ期、Ⅱ期、Ⅲ期患者的比例分别为34.0%、15.0%、51.0%。出院时有62.1%的患者肾功能恢复,37.9%的患者肾功能未恢复。多因素Logistic逐步回归模型分析提示,APACHEⅡ评分(OR 1.139,P<0.05)、行RRT(OR 2.228,P<0.05)是AKI患者预后的独立危险因素,血红蛋白(OR 0.977,P<0.05)是AKI患者预后的保护性因素。结论:AKI预后与肾脏损伤严重程度相关。血容量不足、感染是引起AKI最常见的病因,老年人是AKI高危人群。APACHE II评分、行RRT是AKI患者预后的独立危险因素,血红蛋白是AKI患者预后的保护性因素。

Objective： To investigate the clinical characteristics of patients with acute kidney injury（ AKI） and to find out the prognostic factors,so as to provide evidence for clinical treatment of AKI. Methods： The demographic data,etiology,serum markers,clinical treatment and so on were analyzed retrospectively. According to the renal function at discharge,the patients were divided into the recovery group and the nonrecovery group,and the related factors of AKI prognosis were analyzed. Results： A total of 206 patients with AKI were enrolled in this study,with a male to female ratio of 2. 03∶ 1 and an average age of（ 55. 53 ± 21. 19） years old.Hypovolemia and infection were the most common causes of AKI,and the elderly were high-risk groups of AKI. The proportion of patients with AKI stage Ⅰ,stage Ⅱ and stage Ⅲ were 34. 0%,15. 0% and 51. 0% respectively. Renal function was recovered in62. 1% of the patients and renal function was not restored in 37. 9% of the patients at discharged. Multivariate Logistic regression analysis showed that APACHE II score（ OR 1. 139,P〈0. 05） and requiring RRT（ OR 2. 228,P〈0. 05） were independent risk factors for the prognosis of AKI patients. Hemoglobin（ OR 0. 977,P〈0. 05） was independent protective factors for the prognosis of AKI patients. Conclusion： The prognosis of AKI was associated with the severity of renal injury. The main causes of AKI were hypovolemia and infection,and the elderly were high-risk groups of AKI. APACHE II score and requiring RRT were independent risk factors for the prognosis of AKI patients. Hemoglobin was independent protective factors for the prognosis of AKI patients.