AKIN与RIFLE诊断标准在心脏手术患者中急性肾损伤的发病率的应用研究  被引量:1

Comparison of AKIN and RIFLE Diagnosis Criteria for Evaluating the Incidence and Prognosis of AKI after Cardiac Surgery

在线阅读下载全文

作  者:谭向来[1] 周竹[1] 孔露娇 何苗苗[1] 普俊波 刘佳[2] 

机构地区:[1]昆明医科大学第一附属医院肾脏内科,云南昆明650032 [2]中山大学中山医学院,广东广州510080

出  处:《昆明医科大学学报》2014年第12期74-77,共4页Journal of Kunming Medical University

基  金:云南省科技厅-昆明医科大学联合专项基金资助项目(2011FB180)

摘  要:目的探讨早期诊断心脏术后急性肾损伤(acute kidney injury,AKI)的标准,比较急性肾损伤网(acute kidney injury network,AKIN)及RIFLE标准对心脏术后AKI的发病率及预后差异.方法收集昆明医科大学第一附属医院心外科2012年6月至2013年6月期间所有行心脏手术的住院患者资料,根据AKIN与RIFLE诊断标准,对心脏术后AKI患者的发病率进行统计学分析,比较AKIN及RIFLE标准对心脏术后AKI的发病率差异,并对心脏术后AKI患者进行电话随访调查,观察比较患者长期预后情况.结果 (1)548例心脏手术患者中,根据RIFLE标准诊断心脏术后AKI的发生,与AKIN标准比较,发现AKIN标准诊断的l期AKI的发生率与相对应的RIFLE标准诊断的Risk期AKI的发生率明显升高,而2期AKI的发生率与Injury期AKI的发生率明显下降(P<0.05),对于两者诊断的Ⅲ期AKI发生率无明显差别,两者差异无统计学意义(P>0.05);(2)对于2诊断标准在AKI患者预后比较发现,AKIN标准对患者预后没有表现出优势.在对AKI患者进行电话随访调查中,53例参与随访,28例出现失访,失访率为34.57%;随访患者第1月、第3月、第6月肾功能与出院时肾功能比较,差异无统计学意义(P>0.05).结论 (1)AKIN标准较RIFLE标准诊断术后AKI发病率稍高,但差异没有达到统计学意义;(2)AKIN与RIFLE两标准比较,对改善心脏术后AKI患者的预后无明显差异;(3)AKI患者出院后肾功能与出院时肾功能比较无明显差异.Objective To explore the criteria for early diagnosis of AKI after cardiac surgery and compare AKIN and RIFLE standard for evaluating the incidence and prognosis of AKI after cardiac surgery.Methods We retrospectively collected the data of all hospitalized patients undergoing cardiac surgery in the First Affiliated Hospital of Kunming Medical University from June 2012 to June 2013.According to AKIN and RIFLE standard,the incidence of post-operative AKI in patients was statistically analyzed.The incidence of post-operative AKI was compared between RIFLE and AKIN standard,and the AKI patients after cardiac surgery were followed.Results (1) In 548 patients with cardiac surgery,the incidence of AKI in stage Ⅰ after cardiac surgery evaluated by AKIN criteria was significantly higher,while the incidence of AKI in stage Ⅱ was significantly lower than that by RIFLE (P<0.05),the incidence of AKI in stage Ⅲ had no significant difference between the two criteria (P>0.05).(2) Comparison of two diagnostic standard in the prognosis of patients with AKI showed that AKIN standard had no demonstrated advantages in evaluating the prognosis of AKI.Telephone follow-up of the AKI patients showed that 53 cases were involved in the follow-up,28 cases were lost during follow-up period,the loss rate was 34.57%.The renal function of patients with AKI in the 1th month,the 3th month,the 6th month in the follow-up had no statistically significant difference with that at discharge from hospital.Conclusions (1) The incidence of postoperative AKI evaluated by AKIN criteria is slightly higher than that evaluated by RIFLE criteria,but the difference had no statistical significance.(2) The AKIN criteria and RIFLE criteria have no significant difference in improving AKI prognosis after cardiac surgery.(3) The renal function after hospital discharge and at discharge from hospital has no significant difference.

关 键 词:心脏手术 急性肾损伤 诊断标准 长期预后 

分 类 号:R692.5[医药卫生—泌尿科学]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象