腹腔感染引起的脓毒性休克患者发生急性肾损伤的危险因素分析

Analysis of risk factors for acute kidney injury in patients with septic shock caused by intra⁃abdominal infection

目的研究ICU入院时因腹腔感染引起的脓毒性休克患者发生急性肾损伤的危险因素。方法回顾性分析129例腹腔感染引起的脓毒性休克患者的临床资料,根据是否发生脓毒性休克相关急性肾损伤(AKI)分为AKI组56例,非AKI组73例。采用单因素分析法比较两组临床资料,Logistic回归分析腹腔感染引起的脓毒性休克患者发生急性肾损伤的危险因素,应用ROC曲线评价活化部分凝血活酶时间(APTT)、降钙素原(PCT)在诊断AKI方面的能力。结果AKI组PCT、APTT、血清白蛋白(Alb)等指标与非AKI组比较差异均有统计学意义(P<0.05);APTT,PCT是患者发展为AKI的独立危险因素(P<0.01),Alb是AKI的保护因素(P<0.05);APTT和PCT曲线下面积(AUC)均>0.8,APTT灵敏度和特异性分别为75.0%、85.2%,PCT灵敏度和特异性分别为73.4%、74.1%。结论腹腔感染引起的脓毒性休克患者,入ICU时的APTT、PCT水平是AKI风险增加的独立危险因素,Alb是AKI风险增加的保护因素;APTT和PCT在评估脓毒性休克患者发生AKI方面具有一定的诊断效能。

Objective To investigate the risk factors of acute kidney injury in patients with septic shock caused by intra⁃abdominal infection.Methods 129 patients were enrolled and then 56 cases were divided into in AKI group and 73 cases in non⁃AKI group.The clinical data of the two groups were compared by univariate analy⁃sis.Multiple logistic regression analysis was used to analyze the risk factors of Septic acute kidney injury in ICU patients.Using ROC curve to evaluate the ability of APTT and PCT in diagnosing AKI.Results Compared with the non⁃AKI group,PCT,APTT,serum albumin(Alb)et.al were statistically significant in AKI group(all P<0.05).APTT,PCT were independent risk factors for S⁃AKI(P<0.01),and Alb was known as an independent protective factor for Septic acute kidney injury(P<0.05);The area under the curve(AUC)of APTT and PCT was greater than 0.8,the sensitivity and specificity of APTT and PCT were 75.0%,85.2%,73.4%,74.1%respectively.Conclusion APTT and PCT level on admission to the ICU are significantly associated with acute kidney injury in patients with septic shock caused by intra⁃abdominal infection,and Alb level is known as an independent protec⁃tive factor;APTT and PCT have certain diagnostic efficacy in evaluating Septic acute kidney injury.