脓毒症患者并发急性肾损伤危险因素分析

Analysis of risk factors for complicating acute kidney injury in sepsis patient

目的探索脓毒症患者发生急性肾损伤(AKI)的危险因素。方法回顾性分析2016年7月至2017年1月入住该院重症监护病房的69例脓毒症患者的病历资料,分析其发生AKI的危险因素。结果 69例患者中发生AKI 39例,发生率为56.5%。脓毒症AKI组患者急性生理和慢性健康估测评分Ⅱ,以及白细胞、中性粒细胞绝对值、血小板计数、碳酸氢根、二氧化碳分压、乳酸、氯离子、总胆红素、降钙素原、脑钠肽水平与脓毒症非AKI组比较,差异均有统计学意义(P<0.05);白细胞、乳酸、二氧化碳分压为发生AKI的独立危险因素(优势比=1.089、1.800、0.893,95%可信区间:1.017~1.166、1.250~2.592、0.825~0.967,P=0.015、0.002、0.005)。结论白细胞、乳酸及二氧化碳分压是脓毒症患者并发AKI的独立危险因素。

Objective To explore the risk factors for acute kidney injury(AKI)occurrence in the sepsis patients.Methods The medical record data of 69 inpatients with sepsis in ICU of this hospital from July 2016 to January 2017 were retrospectively analyzed.Then the risk factors of acute kidney injury occurrence in these cases were analyzed.Results Among 69 cases of sepsis,39 cases of AKI occurred with the incidence rate of 56.5%.There were statistically significant differences in the ApacheⅡscore,leukocyte,absolute value of neutrophils,platelet count,partial pressure of carbon dioxide,bicarbonate radical,lactic acid,chloride ion,total bilirubin,procalcitonin and BNP between the patients with complicating AKI and patients without complicating AKI(P<0.05).Leukocyte(OR=1.089,95%CI:1.017-1.166,P=0.015),lactic acid(OR=1.800,95%CI:1.250-2.592,P=0.002)and partial pressure of carbon dioxide(OR=0.893,95%CI:0.825-0.967,P=0.005)were the independent risk factors for complicating AKI in the sepsis patients.Conclusion Leukocyte,lactic acid and partial pressure of carbon dioxide are the independent risk factors for complicating AKI in sepsis patients.