重症病房老年糖尿病患者脓毒症相关急性肾损伤的发生及预后  

Morbidity and Prognosis of Sepsis-Associated Acute Kidney Injury in Elderly Patients with Diabetes Mellitus in ICU

作　　者：翟文亮[1] 王长远[1] 王晶[1] 李俊芬[1] 孙长怡[1] 

机构地区：[1]首都医科大学宣武医院急诊科,北京100053

出　　处：《医学综述》2017年第19期3938-3941,共4页Medical Recapitulate

摘　　要：目的分析重症病房中合并糖尿病的老年脓毒症患者急性肾损伤(AKI)发病情况及短期预后。方法选择2015年6月至2016年6月首都医科大学宣武医院急诊科收治的94例确诊为脓毒症且年龄≥60岁的患者为研究对象,根据是否患有糖尿病,分为糖尿病组(40例)和非糖尿病组(54例),比较两组患者AKI的发生情况以及严重程度,比较两组患者的病死率以及同一组不同AKI程度的病死率。结果 94例脓毒症患者中有48例患者发生AKI,AKI的发生率为51.1%(48/94),糖尿病组患者AKI的发生率与严重程度均高于非糖尿病组[65%(16/40)比40.7%(7/54)](P<0.05),但两组患者病死率比较差异无统计学意义(P>0.05)。结论合并糖尿病的老年脓毒症患者AKI的发生率高,病情严重,AKI级别越高,病死率越高,但与是否患有糖尿病无关。Objective To analyze the morbility and short-term prognosis of acute kidney injury（ AKI） in elderly patients with diabetes mellitus and sepsis in ICU. Methods A total of 94 patients ≥60-year-old presenting with sepsis in emergency department of Xuanwu Hospital of Capital Medical University from Jun. 2015 to Jun. 2016 were included in the study. All patients were divided into a diabetes mellitus（ DM） group（ n = 40） and a non-DM group（ n = 54） according to the diabetes existence. The morbility,severity of AKI and mortality were compared between the two groups,the mortality of different levels of AKI was also compared. Results Aruong 94 sepsis patients,there were 48 patients with AKI,and the incidence of AKI was 51. 1%（ 48/94）. The morbility and degree of AKI in the DM group were significantly higher than those of the non-DM group[65%（ 16/40） vs 40. 7%（ 7/54） ]（ P 0. 05）,but there was no significant difference on mortality（ P 0. 05）. Conclusion The morbility and degree of sepsis-associated AKI in elderly patients with DM are higher,the mortality increases with AKI degree,no matter with DM or without DM.

关 键 词：脓毒症 急性肾损伤 糖尿病 老年患者 

分 类 号：R592[医药卫生—老年医学] R587.1[医药卫生—内科学]