新生儿急性肾损伤预后危险因素分析

Prognostic Risk Factors of Neonatal Acute Renal Injury

目的探讨影响新生儿急性肾损伤(acute kieney injury,AKI)预后的危险因素。方法回顾性收集2015年6月—2021年6月沈阳市妇婴医院收治的因各种原因导致的AKI新生儿病例324例,依据治疗结局分为对照组(非死亡组)277例和观察组(死亡组)47例,收集全部入组患儿的各项临床资料并进行组间比较,筛选导致不良预后的危险因素。结果观察组患儿无尿比例、钾离子、肌酐、尿素氮、急性期蛋白、使用呼吸机比例高于对照组,而出生体质量、Apgar评分、红细胞、血红蛋白、白蛋白低于对照组,差异有统计学意义(P<0.05)。多因素分析显示,无尿、低Apgar评分、高血钾、低蛋白、高尿素氮和使用呼吸机是新生儿AKI预后不良的独立危险因素(P<0.05)。结论影响新生儿AKI预后的危险因素较多,与其关系最密切的是尿量、Apgar评分、血钾、白蛋白、尿素氮和呼吸机使用情况。

Objective To investigate the risk factors influencing the prognosis of acute kidney injury(AKI)in neonates.Methods Retrospective collection of 324 cases of newborn AKI from June 2015 to June 2021 due to various causes was conducted in Shenyang Maternity and Infant Hospital.They were divided into control group(non death group,n=277 cases)and research group(death group,n=47 cases)according to the treatment outcome.The clinical data of all enrolled children were collected and compared with the components to screen the prognostic risk factors.Results The proportions of anuria,potassium ions,creatinine,urea nitrogen,acute phase protein and ventilator use in the observation group were significantly higher than those in the control group,while the birth weight,Apgar score,red blood cells,hemoglobin and albumin in the observation group were significantly lower than those in the control group(P<0.05).Multivariate analysis showed that anuria,low Apgar score,high blood potassium,low protein,high urea nitrogen and ventilator use were independent risk factors for poor prognosis of neonatal AKI(P<0.05).Conclusion There are many risk factors affecting the prognosis of neonatal AKI,and the most closely related factors are urine volume,Apgar score,blood potassium,albumin,urea nitrogen and ventilator use.