影响儿童重症病房新生儿发生急性肾损伤及预后相关因素分析  

Relevant Factor Analysis of Pathogenesis and Prognosis of Neonatal Acute Kidney Injury

作　　者：张毅[1,2] 谢坚[1] 刘亚琼[1] 赵荣香[1] 胡陶[1] 赵凤华[1] 郭军[1] 

机构地区：[1]绵阳市中心医院儿科,四川绵阳621000 [2]华西医科大学临床医学院,四川成都610041

出　　处：《现代生物医学进展》2016年第24期4698-4701,共4页Progress in Modern Biomedicine

基　　金：四川省卫生厅科研基金项目(090048)

摘　　要：目的:评估在儿童重症病房(PICU)中治疗的新生儿发生急性肾损伤(AKI)及影响预后的相关因素。方法:对在我院PICU治疗的215例新生儿进行回顾性研究,采用KDIGO标准对患儿进行诊断与分级,根据新生儿是否发生AKI将新生儿分为AKI组(n=75)与非AKI组(n=140),收集并比较二组患者的临床资料,采用多元逻辑回归分析PCIU新生儿发生AKI的危险因素与AKI预后相关因素。结果:单因素逻辑回归分析表明,菌血症(OR=5.34,95%CI:1.37-20.33,P=0.013)、较低基线e GFR(OR=0.93,95%CI:0.89-0.97,P=0.002)与最大钠浓度(OR=1.11,95%CI:1.03-1.25,P=0.022)为新生儿发生AKI的独立相关因素。死亡率、长期LMV只与AKI(Ⅱ+Ⅲ)阶段相关(P<0.05),而LOS无论调整前后均只与AKI(Ⅱ+Ⅲ)阶段相关(P<0.05)。结论:PCIU治疗的AKI新生儿死亡率增加,菌血症、较低基线估计肾小球滤过率和最大钠浓度与急性肾损伤独立相关。Objective： To evaluate the relevant factors of acute kidney injury （AKI） incidence of neonates in pediatric intensive care unit （PICU）, and to investigate the factors on its prognosis. Methods： Retrospective analysis was performed on the data of the 215 neonates in the PICU of our hospital. The KDIGO standard was applied to diagnose and classify AKI. The neonates were divided into AKI group （n=75） and non-AKI group （n= 140）. We collected and compared the clinical data of the two groups of patients, and analyzed the relevant factor of pathogenesis and outcome of neonatal acute kidney injury with multivariate logistic regression. Results： Univariate logistic regression analysis showed that Bacteremia （OR=5.34, 95% CI： 1.37-20.33, P=0.013）, lower baseline eGFR （OR=0.93, 95% CI： 0.89-0.97, P=0.002） and the maximum concentration of sodium （OR=1. 11, 95% CI： 1.03-1.25, P =0.022） were independently relevant factors of the neonatal AKI. Mortality and long-term LMV were only associated with AKI （ II ＋III） （P〈0.05）. And LOS was only associated with AKI （ II ＋III） whenever before and after adjusting relevant factors. Conclusion： AKI increased neonatal mortality in PCIU. Bacteremia, lower baseline estimated glomerular filtration rate and maximum sodium concentration were independently correlated with AKI.

关 键 词：急性肾损伤 儿童重症病房 新生儿 

分 类 号：R725[医药卫生—儿科] R692[医药卫生—临床医学]