糖尿病肾病合并急性肾损伤97例的临床特征分析  

An analysis about the clinical feature of 97 cases diabetic nephropathy complicated with acute kidney injury

作　　者：张丽[1] 王惠新[1] 

机构地区：[1]江苏省徐州市中心医院肾内科,江苏徐州221009

出　　处：《中国现代医生》2015年第29期18-21,共4页China Modern Doctor

摘　　要：目的探讨糖尿病肾病（DN）患者合并急性肾损伤（AKI）的临床特征，为改善患者的预后提供依据。方法回顾性分析2011年1月～2015年4月期间我院肾内科97例DN合并AKI患者的临床资料及其临床特征。结果97例AKI患者中52例并发感染（53．6％），包括呼吸系统、泌尿系统、皮肤感染等。DN并发AKII、Ⅱ、Ⅲ期分别为12例（12．4％）、45例（46．4％）和40例（41．2％）。肾前性是AKI发生的重要病因，感染、心力衰竭伴低血压、高血压、肾毒性药物等是AKI的重要诱发因素。与DN患者预后相关的因素包括年龄、最高Cr、UACR水平、基础GFR、尿素氮等（P〈0．05）。康复组与未康复组患者分别为52例（53．6％）和45例（46．4％），住院期间死亡4例（4．1％）。结论DN合并AKI的发生受多种因素影响，感染是导致DN患者发生AKI的首要因素。重视AKI发生的病因及影响其预后的高危因素，对于早期诊断和防治AKI具有重要意义。Objective To investigate the clinical feature of AKI with DN, to expect to provide a reference for the clini- cal prognosis. Methods Implemented a retrospective analysis about the clinical data of 97cases patients with AKI and DN,which had treated in our hospital during Jan 2011 to Apr 2015, and investigated the clinical characteristics of these patients. Results Among the 97 cases patients, 52 cases happened infection, contained respiratory system infection, uri- nary system infection,skin infection. The results showed, 12 eases（12.4%） in the stage I of AKI,45 cases（46.4%） in stageⅡ of AKI,40 cases （41.2%） in stage Ⅲ of AKI. Prerenal was the main cause of AKI,infection,heart failure complicated with hypotension, hypertension, and drugs of renal toxicity were the important induce factors of AKI. Prog- nosis related factors of DN were age, highest Cr, UACR level, basic GFR and urea nitrogen （P〈0.05）. Rehabilitation group patients and the other patients were 52 cases（53.6%） and 45 cases （46.4%）,respectively,4 cases（4.1%） dead during hospitalization. Conclusion The incidence of DN complicated with AKI is induced by many factors. The infec- tion is primary induce factor for AKI. Pay more attention on the causes of AKI and the risk factors related with progno- sis are very important for the early diagnosis and prevention of AKI.

关 键 词：糖尿病肾病 感染 急性肾损伤 预后 

分 类 号：R587.2[医药卫生—内分泌]