不同年龄老年急性肾损伤临床和预后调查分析  

Survey and analysis of clinical features and prognosis in elderly acute kidney injury patients with different age

作　　者：王婷婷[1] 秦燕[1] 刘翠萍[1] 李亚伟[1] 薛宇[1] 

机构地区：[1]北京老年医院,北京100095

出　　处：《医药论坛杂志》2015年第4期16-19,共4页Journal of Medical Forum

摘　　要：目的不同年龄老年急性肾损伤临床特点和预后,探索影响老年AKI预后的危险因素。方法选择北京老年医院193例老年AKI为研究对象,依据年龄分为60-69岁、70-79岁和≥80岁三个年龄亚组分析比较三组患者的临床和预后资料,并采用多因素回归分析评估影响老年AKI预后的危险因素。结果三组患者基础血清肌酐无统计学差异,≥80岁年龄亚组患者发生AKI后血清肌酐水平显著高于其他两个年龄亚组（F=7.152,P=0.027）。≥80岁年龄亚组患者高血压合并症的患病率为74.42%,显著高于60-69岁和70-79岁年龄两个年龄亚组,分别为74.42%vs42.86%,χ^2=68.433 P〈0.001和74.42%vs58.62%,χ^2=82.922 P〈0.001;病因构成中,60-69岁、70-79岁和≥80岁年龄亚组患者分别以肾性、肾前性和肾后性最为常见,分别占57.14%、60.47%和6.90%。随着年龄增长,AKI 3级的发生率呈逐渐升高趋势,三个年龄亚组分别为23.81%、25.29%和39.35%,但无显著性差异（χ^2=3.706 P=0.157）。随访中,共有65例患者死亡,死亡率为33.68%。≥80岁年龄亚组患者死亡率（48.84%）显著高于60-69岁（19.05%）和70-79岁（36.78%）亚组患者（χ^2=10.836 P=0.004）。多因素Logistic回归分析显示年龄和MODS成为老年AFR死亡独立危险因素,死亡风险比分别为1.435,95%CI（1.223-3.463）和4.203,95%CI（1.784-9.532）。结论年龄是影响老年AKI预后的一个危险因素,高龄老年AKI患者临床合并高血压率高、死亡率高。Objective To analyze the clinical features and prognosis in elderly acute kidney injury patients with different age,to explore the risk factors of the prognosis in elderly AKI patients. Methods Totally 193 elderly AKI patients of our hospital were chose for the study. According to age,they were divided into three subgroups： 60 to 69 years,70 to 79 years and ≥80 years old. Data of the clinical features and prognosis in the three subgroups were compared and analyzed. And the risk factors of the prognosis in elderly AKI patients were assessed after multiple variable regression analysis. Results There were no statistical differences in base serum creatinine levels among the three groups. After the occurrence of AKI,the serum creatinine levels of patients in ≥80 years age subgroup were obviously higher than other two age subgroups（ F = 7. 152,P = 0. 027）. The prevalence rate of hypertension in ≥80 years age subgroup was 74. 42%and obviously higher than other two age subgroups＇. The statistical differences were 74. 42% vs42. 86%,χ^2= 68. 433 P 0. 001 and 74. 42% vs58. 62%,χ^2= 82. 922 P〈 0. 001 separately. The etiologies of patients in the three age subgroups： 60 to 69 years,70 to 79 years and ≥80 years old,mainly are renal,prerenal and postrenal separately; which accounted for 57. 14%,60. 47% and 6. 90% separately. With age,the incidence rates of AKI 3- stage in the three age subgroups increased gradually and respectively were 23. 81%,25. 29% and 39. 35%. But there was no significant difference（ χ^2= 3. 706 P = 0. 157）. During the follow- up,65 patients died and the mortality was 33. 68%. The mortality of patients in ≥80 years age subgroup was significantly higher than in 60 to 69 years age subgroup（ 19. 05%） and 70 to 79 years age subgroup（ 36. 78%）（ χ^2= 10. 836 P = 0. 004）. Multiple variable Logistic regression analysis showed that age and MODS were independent risk factor in death of elderly AFR patients. Conclusion Age is a risk factor of the prognosis in elderly AKI pati

关 键 词：老年人 急性肾损伤 老年 预后 

分 类 号：R692[医药卫生—泌尿科学]