130例急性肾衰竭的病因及预后分析  

Etiology and prognosis of 130 patients with acute renal failure

作　　者：刘其锋[1] 邱红渝[1] 陶冶[1] 博虹[1] 王雪蓉[1] 

机构地区：[1]四川大学华西医院肾脏内科,四川成都610041

出　　处：《西部医学》2008年第2期271-273,共3页Medical Journal of West China

摘　　要：目的探讨急性肾功能衰竭(ARF)的病因、临床特点及预后因素。方法回顾性分析130例住院的急性肾功能衰竭患者的临床资料,分析其原发病和病因、临床特点、合并症、治疗方法,同时分析病死率及影响预后的因素,分析过程中将患者分为老年组和非老年组。总结出老年组和非老年组的病因特点,与肾功能衰竭发生相关的危险因素,并针对危险因素提出相应的防治方法。结果ARF患者性别构成稳定,老年患者有增多的趋势;肾前性45例,老年组以肾前性、肾性因素为主,其中胃肠道失液占有很大比重;肾性73例,非老年组以肾性因素为主;药物相关ARF占很大比重,抗生素仍为本组的主要原因,非甾体类抗炎药所占比重增加;肾后性12例,病因为泌尿道的梗阻;住院日、少尿日、肾脏大小、Bun、Crea在两组间没有差别,但老年组中肺部感染、肝损害、多器官功能不全的比显高于对照组,老年组的病死率高于对照组;血液透析治疗组存活率高于其他治疗组。结论引起急性肾衰竭的原因很多,胃肠道失液及药物相关ARF仍为主要原因,老年人ARF有增多的趋势,需引起注意;及早进行血液透析能改善病情,提高存活率;年龄、器官损伤数目是影响预后的重要因素;老年人往往患有各种慢性病,极易诱发ARF,对此应提高警惕。Objective To discuss the etiology, clinical characteristics, and prognosis of acute renal failure （ARF）. Methods 130 patients with ARF admitted to our department were retrospectively investigated. The etiology, incidence of ARF, clinical characteristics, treatments and prognosis were analyzed. All patients were divided into elderly group and non-elderly group. The features of etiologic profiles between the two groups, the risk factors of ARF and appropriate treatments regimens were summarized. Results were elderly patients. Fluid loss from gastrointestinal tract Out of the 45 patients with pre-renal ARF, most of them was the main cause especially in elderly patients. Among 73 patients with renal ARF, drugs especially antibiotics associated ARF were the main cause, in which nonsteroid anti- inflammatory drugs had an increasing trend. In 12 patients with post-renal ARF, the etiology was urinary tract obstruction. There was no significant difference in Bun, Crea, and hospital stay between the two groups. Elderly patients had a high ratio of complications and mortality. Hemodialysis could reduce the mortality. Conclusions There is an increasing trend in the incidence of ARF in elderly patients. Fluid loss from the gastrointestinal tract and nephrotoxic drugs are the primary cause of ARF. The early use of hemodialysis can increase survival rate. Age and the number of organ system injury are more vulnerable to death, so more attention should be paid to elderly patients who are more easily attacked by ARF.

关 键 词：急性肾衰竭 病因 预后 血液透析 连续性肾脏替代治疗 

分 类 号：R692.5[医药卫生—泌尿科学]