脓毒症患者并发急性肾损伤的危险因素探讨  

Risk factors for acute kidney injury in sepsis patients

作　　者：范妙仪[1] 刘蔓莉[1] 张磊[2] 舒英[1] 皮婧静[1] 全大勇[1] 龚蓉[1] 

机构地区：[1]成都市第三人民医院肾内科,四川成都610036 [2]成都中医药大学附属医院泌尿外科,四川成都610041

出　　处：《实用医院临床杂志》2017年第5期52-55,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨脓毒症患者发生急性肾损伤的危险因素。方法回顾性分析2012年1月至2016年12月在我院诊治的脓毒症患者的病历资料,回归分析脓毒症患者发生急性肾损伤(AKI)的危险因素。结果 604例脓毒症患者,并发AKI327例(54.1%)。脓毒症并发AKI组和不并发AKI组的性别、年龄、舒张压(DBP)、平均动脉压(MAP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(Scr)差异有统计学意义(P<0.05);合并慢性肾功能不全、高血压、血脂代谢异常、冠心病差异有统计学意义(P<0.05);肺部和腹部感染差异有统计学意义(P<0.05),鲍曼不动杆菌和真菌感染差异有统计学意义(P<0.05)。回归分析发现,男性、MAP、肺部感染是脓毒症患者并发AKI的危险因素。结论男性、MAP、肺部感染是脓毒症患者并发AKI的危险因素。Objective To explore the high risk factors for acute kidney injury （AKI） in sepsis patients. Methods We retro- spectively analyzed the general information, clinical data, infection pathogens, infection sites and other indicators of 604 patients who were diagnosed as sepsis from January 2012 to December 2016 in our hospital. Then, we analyzed the risk factors of acute kidney injury in these patients. Results In the 604 patients with sepsis,the incidence of sepsis complicated with AKI was 54. 1% （327/604）. There were sig- nificant differences in gender, age, DBP, MAP, ALT, AST, Ser and BUN between the patients complicated with AKI and without AKI （ P 〈 0. 05 ）. There also were significant differences in combination of chronic renal insufficieney,hypertension,dyslipidemia and coronary heart disease and pathogens of Acinetobacter baumannii and Fungi as well as lungs and abdomen of infection location between the patients com- plicated with AKI and without AKI （P 〈0. 05 ）. Regression analysis showed that male, MAP and pulmonary infection were risk factors for AKI in the sepsis patients. Conclusion Male, MAP and pulmonary infection are risk factors for AKI in sepsis patients.

关 键 词：脓毒症 急性肾损伤 危险因素 

分 类 号：R692.9[医药卫生—泌尿科学]