新疆石河子大学医学院第一附属医院ICU住院患者急性肾损伤患病现况调查及预后分析
Prevalence survey and prognosis analysis of acute kidney injury in the intensive care unit of First Affiliated Hospital of Medical College，Shihezi University,Xinjiang

潘鑫,程青虹,马雅静,赵丹,张春江,杨晓萍.新疆石河子大学医学院第一附属医院ICU住院患者急性肾损伤患病现况调查及预后分析[J].内科急危重症杂志,2017,23(3):

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英文关键词:ICU kidney injury acute prevalence etiology survival risk factors

基金项目:

作者	单位	E-mail
潘鑫	新疆石河子大学医学院	1032941792@qq.com
程青虹	新疆石河子大学医学院
马雅静	新疆石河子大学医学院
赵丹	新疆石河子大学医学院
张春江	新疆石河子大学医学院
杨晓萍	新疆石河子大学医学院	sbkyxp@163.com

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中文摘要:

目的：探讨ICU住院患者急性肾损伤（acute kidney injury，AKI）患病情况及预后情况，并对预后相关的危险因素进行分析。方法：收集新疆石河子大学医学院第一附属医院2015年1月至2015年12月在ICU住院治疗患者资料，对于发生AKI的患者组成队列研究，回顾性分析ICU住院患者AKI的发生率、病因、病死率等流行病学情况，并采用Logistic回归分析预后的危险因素。结果：2015年1月至2015年12月ICU住院患者共655例，其中109例发生AKI，发病率为16.6%，男性患者87，女性患者22例，男女比例（3.95:1）。发生AKI起第7天观察时，63例存活，46例死亡，病死率42.2%；出院作为观察结局时，死亡患者54例，存活患者55例，病死率49.54%。发生AKI患者以住院期间最后一次肌酐检测值作为肾功预后判断指标，17.4%的患者肾功完全恢复，39.4%的患者肾功部分恢复，37.6%的患者肾功未恢复。多因素Logistics回归分析低血压（OR=6.338）、昏迷（OR=4.417）、APACHE-II评分（OR=1.453）是患者死亡预后的独立危险因素。肾脏预后相关的因素包括年龄、贫血、使用抗生素、出血。结论：AKI是ICU住院患者中越来越普遍并且或将成为灾难性的并发症。一旦发生AKI，患者病死率高、肾脏功能不易完全恢复。昏迷、低血压、APACHE-II评分是患者死亡的独立危险因素；年龄、贫血、使用抗生素、出血是患者肾脏功能预后的相关因素。

英文摘要:

Objective： The objectives of this study were to investigate the prevalence and the prognosis of acute kidney injury(AKI) in ICU and to find out the risk factors associated with the outcome.Methods:Between Jan．to Dec.2015 all the hospitalized patients in ICU of First Affiliated Hospital of Medical College were screened by Laboratory data retrieval system .Our Study cohort was comprised of all the patients with AKI.The prevalence were retrospectively analyzed．Logistic regression analysis was used to investigate the risk factors of mortality and renal prognosis.Results:Of all the 655 hospitalized patients, 109 patients with AKl ，the prevalence was 16.6%.The ratio of male to female was(3.95:1).The average hospitalization time was（18.27 15.73） days. On day 7 after AKI,the mortality rate was 42.2%（46/109）;In the final observation,the mortality rate was 49.54%,(54/609)，complete renal unrecovery rate was 37.6％．partial renal recovery rate was 39.4％、complete renal recovery rate was 17.4%.Multivariate Logistic regression analysis showed that the independent risk factors for mortality were hypotension（OR=6.338）、coma（OR=4.417）、APACHE-II score（OR=1.453）。Age、anemia、the use of antibiotics，hemorrhage associated with renal outcome. Conclusions :Acute kidney injury is an increasingly common and potentially catastrophic complication in ICU patients. The patient with AKI will have high mortality, renal function is not easy to fully recover. hypotension、coma、APACHE-II score were the independent risk factors for mortality . Age,anemia,hemorrhage,the use of antibiotics associated with renal outcome.