AKIN和RIFLE标准评估重症监护病房（ICU）患者急性肾损伤的对比研究  

Comparative study to assess incidence and mortality of AKI patients in ICU by using AKIN and RIFLE criteria

作　　者：张康羿[1] 周姣姣[1] 杨立川[1] 苏晓凤[1] 刘运[1] 

机构地区：[1]四川大学华西医院,成都610041

出　　处：《临床肾脏病杂志》2012年第11期494-496,共3页Journal Of Clinical Nephrology

摘　　要：目的以AKIN和RIFLE诊断标准评估重症监护病房（ICU）患者急性肾损伤（AKI）的发病率以及预后，探讨AKIN与RIFLE标准的优缺点。方法回顾性分析2009年7月至2010年4月入住四川大学华西医院ICU的4642例患者的临床资料。结果最终人选患者1036例，应用RI-FI。E标准诊断发生AKI的患者273例（26．7％），应用AKIN标准诊断发生AKI的患者353例（34．1％），两种标准诊断AKI的发生率的差异有统计学意义（P〈0．05）。RIFLE标准预测AKI患者短期院内死亡的R（X2曲线下面积为0．703（P〈O．01），AKIN标准预测AKI患者短期院内死亡的RCK；曲线下面积为0．757（P〈0．01），两种标准在预测患者死亡的差异方面无统计学意义（P〉0．05）。结论RIFI。E标准与AKIN标准均能较好地诊断AKI，AKIN标准更敏感，但在预测ICU中AKI患者的短期死亡方面两种标准的差异无统计学意义。Objective To evaluate the occurrence and prognosis of acute kidney injury （AKI） by using both the acute kidney injury network （AKIN） criteria and the risk injury failure loss of kidney function, end-stage kidney disease（RIFLE） classification, for patients in intensive care unit （ICU）. And to explore the advantages and disadvantages of RIFLE criteria and AKIN standard. Methods A retrospective study was conducted in 4642 patients admitted to the ICU in West China Hospital of Si- chuan University from July 2009 to April 2010. Results In all 1036 patients evaluated, AKI were 273 cases and 353 cases, respectively, by RIFLE and AKIN criteria. The AKI incidence by RIFLE （26. 7 %）, and AKIN （34. 1 %） were significantly different （P%0. 05）. In all patients, the area under the receiver operator characteristic curve （ROC curve）, the index for the short-term hospital mortality prediction, was 0. 703 and 0. 757 for RIFLE and AKIN, respectively （P%0. 0 1）. No significant difference was found between the total mortality by the two criteria （P〉0. 05）. Conclusions The A- KIN criteria and RIFLE criteria both are good predictors of AKI, but AKIN criteria is more sensitive. However, no significant difference was found between the two criteria to predict AKI patients in the short-term hospital mortality in critically ill patients.

关 键 词：急性肾损伤 AKIN标准 RIFLE标准 

分 类 号：R692[医药卫生—泌尿科学]