烧伤合并急性肾损伤患者向慢性肾脏病转归的相关因素  

Risk factors of chronic kidney disease following empyrosis combined with acute kidney injury

作　　者：吴海洋[1] 吴灏[1] 魏秋波[1] 丁琳[1] 陈娟[1] 郭志勇[1] 

机构地区：[1]上海长海医院肾内科,上海200433

出　　处：《上海医学》2016年第5期287-290,共4页Shanghai Medical Journal

摘　　要：目的探讨烧伤合并急性肾损伤（AKI）向慢性肾脏病（CKD）转归的相关因素。方法收集2010年1月-2014年12月在上海长海医院烧伤科和烧伤科ICU接受治疗的164例烧伤合并AKI的患者，根据治疗后患者病情的转归将患者分为CKD组和。肾功能恢复组（RRF组），每组各82例。比较两组患者的一般资料，血常规、肾功能指标，以及少尿、烧伤休克、脓毒血症、AKI分期患者构成比，并分析烧伤合并AKI向CKD转归的相关因素。结果CKD组白细胞计数显著高于RRF组（PG0．05），少尿、烧伤休克、脓毒血症和行肾脏替代治疗的患者构成比均显著高于RRF组（P值分别d0．05、0．01）。两组间血红蛋白、血清白蛋白、血清肌酐、血清尿素氮、血钠水平、血钾水平和AKI分期患者构成比的差异均无统计学意义（P值均〉0．05）。Logistic单因素回归分析显示，住院期间发生脓毒血症（（）R=5．3，95％CI为2．7～9．8）、烧伤休克（OR=4．6，95％CI为2．3～6．1）、少尿患者构成比（OR=3．2，95％cJ为1．5～4．2）为烧伤合并AKI患者转归为CKD的独立危险因素（P值均G0．05）。Logistic多因素回归分析显示，脓毒血症（OR=4．7，95％CI为2．6～8．1）和烧伤休克（OR=3．8，95％CI为2．1～6．7）为烧伤合并AKI患者转归为CKD的重要影响因素（P值均Go．05）。结论对于烧伤合并AKI的患者，脓毒血症和烧伤休克是患者转归CKD的主要危险因素。Objective To investigate risk factors of chronic kidney disease （OKD） resulting from empyrosis combined with acute kidney injury （AKI）. Methods A total of 164 patients, who suffered from empyrosis with AKI, and were hospitalized in the department of empyrosis and its accessorial intense care unit （ICU） of Changhai Hospital from January 2010 to December 2014, were enrolled in this study. The chronic kidney disease （CKD） group and recovery of renal function （RRF） group were performed in 82 and 82 patients, respectively. The results of blood routine examination, renal function parameters and patient percentage of oliguria, burn shock, sepsis and AKI staging were compared between CKD group and RRF group. Risk factors related to CKD were analyzed. Results The white blood cell count of OKD group was significantly higher than that of RRF （P〈0. 05） so were the incidence rates of oliguria, empyrosis shock and septicopyemia and renal replacement theraph （ P 〈0. 05, 0. 01 ）. However, there were no significant differences in the levels of hemoglobin, serum albumin, serum creatinine（sOr）, blood urea nitrogen （BUN）, serum potassium, or the patient percentage of AKI staging between the two groups （all P〉0.05）. Logistic univariate regression analysis showed that sepsis during hospitalization （OR=5.3, 95%C1= 2.7-9.8,P〈0.05）, burn shock （OR=4.6, 95%Cl= 2.3-6.1, P〈0.05）, and oliguria （OR = 3.2, 95 % OI ： 1.5 - 4.2, P 〈 0.05） were independent risk factors of CKD in patients with AKI. Logistic multivariate regression analysis showed that sepsis （OR = 4.7, 95 % CI ： 2.6- 8.1, P〈0.05）andempyrosis shock （OR =3.8, 95% Cl： 2. 1-6.7, P〈0.05） were two major risk factors. Conclusion Sepsis and empyrosis shock are major risk factors of CKD following empyrosis combined with AKI.

关 键 词：烧伤 慢性 肾脏病 转归 危险因素 

分 类 号：R644[医药卫生—外科学] R692[医药卫生—临床医学]