质子泵抑制剂对儿童急性肾损伤发生的影响

Proton Pump Inhibitors on Acute Kidney Injury in Children

目的:探讨质子泵抑制剂(PPI)对儿童急性肾损伤(AKI)发生的影响。方法:选取中国人民解放军联勤保障部队第九〇四医院2017年1月至2018年12月收治的108例住院患儿,根据是否使用PPI分为使用PPI组(n=24)和未使用PPI组(n=84),比较两组患儿AKI发生率、病死率、住院时间和住院费用的差异,分析住院患儿发生AKI的危险因素。结果:使用PPI的患儿AKI发生率、住院时间和住院费用均高于未使用PPI的患儿,单因素和多因素Logistic回归分析结果显示,高APACHEⅡ评分、使用利尿剂和PPI是住院患儿发生AKI的独立危险因素(P<0. 05)。结论:使用PPI会增加AKI的发生率、延长住院时间、增加住院费用,临床在PPI使用过程中应加强肾功能监测。

Objective: To investigate the effects of proton pump inhibitors( PPI) on acute kidney injury( AKI) in children. Methods:A total of 108 children with AKI admitted into the 904 thHospital of the Joint Support Force of the Chinese People’s Liberation Army from Jan. 2017 to Dec. 2018 were enrolled. According to application history of PPI,all patients were divided into the PPI group( n = 24) and the non-PPI group( n = 84). The incidence,mortality,length of stay and cost of hospitalization of AKI in two groups were compared,and the risk factors of AKI were analyzed. Results: The incidence,mortality,length of stay and cost of hospitalization of AKI in the PPI group were higher than those in the non-PPI group. Univariate and multivariate Logistic regression analysis showed that high APACHE Ⅱscore,diuretic and PPI were independent risk factors for AKI in hospitalized children( P< 0. 05). Conclusion: The use of PPI could increase the incidence of AKI,prolong the length of stay,and increase the cost of hospitalization. Renal function monitoring should be strengthened in the clinical use of PPI.