ICU患者急性肾损伤流行病学分析  

Epidemiology of acute kidney injury in the intensive care unit

作　　者：许丹[1] 吕政[1] 袁世荧[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院综合ICU,武汉430022

出　　处：《临床急诊杂志》2015年第4期253-255,共3页Journal of Clinical Emergency

摘　　要：目的:分析重症监护病房(ICU)患者急性肾损伤(AKI)的发病率、病死率和病因等,筛选出与AKI相关的影响因素。方法:采用急性肾损伤网络(acute kidney injury network,AKIN)诊断标准进行分期回顾性研究。结果:观察期间入选的ICU患者共222例,AKI发病率为32%,其中1期、2期、3期分别占12.2%、5.9%、14.0%。ICU患者病死率为13.1%,AKI患者病死率为36.6%,非AKI患者病死率为2.0%。引起AKI的主要原因为肾性,包括脓毒症、呼吸心跳骤停、恶性肿瘤等。多元Logistic回归分析显示年龄、患者类型、AKI第1天分期及循环衰竭是AKI分期的影响因素,年龄、患者类型、AKI第1天分期、肝功能衰竭及血糖最低值是AKI预后的影响因素,肾上腺素、脓毒性休克是ICU患者病死率的影响因素。结论:ICU患者中,发生AKI的患者病死率更高。年龄、患者来源、AKI第1天分期及循环衰竭是AKI分期的影响因素,年龄、患者来源、AKI第1天分期、肝功能衰竭及血糖最低值是AKI预后的影响因素。Objective：To analyze the incidence,mortality rate and etiology of acute kidney injury（AKI）in ICU,and screen out the impact factors associated with AKI.Method：To analyze patients retrospectively according to the AKIN（Acute Kidney Injury Network）diagnostic criteria and staging criteria.Result：Among the 222 patients in ICU,the morbidity of AKI is 32%,the stage of AKIN-1,2,3are 12.2%,5.9% and 14.0%,respectively.The overall mortality rate of ICU is 13.1%,and the mortality of AKI patients and non-AKI patients are 36.6% and2.0%,respectively.The main etiology of AKI is renal lesion induced by sepsis,respiratory and cardiac arrest,malignancy,and so on.Multivariate logistic regression analysis shows that age,department of patients’ previous admission,stage on the first day of AKI and circulatory failure are the impact factors of AKI staging;age,department of patients’ previous admission,stage on the first day of AKI,hepatic failure and the minimum value of blood glucose are the impact factors of AKI prognosis;epinephrine dose and septic shock are the impact factors of ICU mortality.Conclusion：The mortality of AKI patients is significantly higher than that of non-AKI patients in ICU.Age,department of patients’ previous admission,stage on the first day of AKI and circulatory failure are the impact factors of AKI staging;age,department of patients’ previous admission,stage on the first day of AKI,hepatic failure and the minimum value of blood glucose are the impact factors of AKI prognosis.

关 键 词：急性肾损伤 ICU 流行病学 

分 类 号：R692[医药卫生—泌尿科学]