| 引用本文： |
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戴国兴,苏立杰,华晶,等.急性肾损伤临床研究101例[J].同济大学学报（医学版）,2013,34(6):96-101. [点击复制]
- DAI Guo-xing,SU Li-jie,HUA Jing,et al.Clinical features of 101 cases of acute kidney injury[J].同济大学学报（医学版）,2013,34(6):96-101. [点击复制]
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| 摘要: |
| 目的分析总结急诊科急性肾损伤的临床特点。方法搜集2006年1月-2012年10月于上海市同济医院急诊内科病房和重症监护室EICU住院治疗的各类急性肾损伤患者101例，总结分析其诱因、病因、临床特点以及预后相关的影响因素。结果101例患者，年龄68．52±18．19岁，男性65例（64．4％），女性36例（35．6％），有基础肾脏疾病者9例（8．9％），死亡27例（26．7％）。导致急性肾损伤的常见病因为脓毒症、心衰、中毒等；高龄患者易出现急性肾损伤，不同病因所致急性肾损伤在不同年龄组的比例差别无统计学意义；不同病理生理机制类型急性肾损伤在不同年龄组的比例差别无统计学意义；老年组患者的GFR低于青年组和中年组，中年组与青年组GFR差别无统计学意义；不同年龄组蛋白尿和高血压的比例差别有统计学意义；脓毒症组和非脓毒症组急性肾损伤患者蛋白尿、MODS、死亡比例差别有统计学意义。存活组与死亡组患者年龄、性别比例、蛋白尿比例、MODS比例、基础肾脏疾病比例、脓毒症比例差别有统计学意义，经logistic回归，高龄、脓毒症、蛋白尿、男性、MODS是急性肾损伤患者不良预后的危险因素。结论1．脓毒症、心力衰竭、急诊中毒是导致急性肾损伤的重要病因，高龄患者易发生急性肾损伤，需要引起急诊医生的关注。2．男性、脓毒症、高龄、蛋白尿阳性、MODS是急性肾损伤患者预后不艮的危险因素。 |
| 关键词: 急性肾损伤 流行病学 预后 |
| DOI：10. 3969/j. issn1008-0392. 2013. 06. 022 |
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| 基金项目: |
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| Clinical features of 101 cases of acute kidney injury |
| DAI Guo-xing,SU Li-jie,HUA Jing,WU Xian-zheng,WANG Hao |
| (Dept. of Emergency Medicine, Tongji Hospital, Tongji University, Shanghai 200065, China;Dept. of Special Medicine, Tongji Hospital, Tongji University, Shanghai 200065, China) |
| Abstract: |
| Objective To review the clinical features of acute kidney injury. Methods One hundred and one patients with acute kidney injury were admitted in emergency ward and EICU of Tongji Hospital between January 2006 and October 2012. The clinical features of patients were analyzed. Results There were 65 males （64.4%） and 36 females （35.6%） with an average age of 68.52 ±18.19 years. Nine out of 101 cases had previous kidney disease （8.9%）. The common causes were sepsis, heart failure, toxicosis, respiratory failure, urinary tract obstruction and hypovolemia. There was no significant difference in causes between different age groups, but the pathophysiological types were correlated with different age groups. The GFR of elderly group was lower than that of young and middle-age groups, however, there was no difference between middle and young-age groups. There was significant difference of proteinuira and hypertension in different age groups. The outcomes of patients were correlated with age, gender, proteinuria, MODS and previous kidney disease history. Logistic regression showed that male, older age, proteinuria and MODS were the risk factors of poor prognosis in acute kidney injury patients. Conclusion The results indicate that for male, elderly, proteinuria positive and MODS patients with acute kidney failure it is particularly necessary to prevent the poor prognosis. |
| Key words: acute kidney injury epidemiology prognosis |
