脓毒症相关性肾损伤临床特征及预后分析  

Clinical characteristics and prognostic factors of sepsis related acute kidney injury

作　　者：张珺[1] 尹磊[1] 王昭君[1] 杨晓军[1] ZHANG Jun;YIN Lei;WANG Zhaojun;YANG Xiaojun(ICU,General Hospital of Ningxia Medical University,Yinehuan 750004,China)

机构地区：[1]宁夏医科大学总医院ICU,宁夏银川750004

出　　处：《宁夏医学杂志》2018年第9期807-809,共3页Ningxia Medical Journal

基　　金：宁夏高等学校科学研究项目(NGY2016096)

摘　　要：目的初步分析脓毒症相关性急性肾损伤(SI-AKI)患者的临床特征以及影响预后的因素。方法回顾性分析137例急性肾损伤患者,收集一般资料,使用Logistic回归分析研究其临床特点及影响预后的危险因素。结果 SI-AKI组患者死亡率、APACHEⅡ评分、SOFA评分、乳酸值、AKI 3期所占比例均明显高于非SI-AKI组; 76例SI-AKI患者感染的主要原因为腹腔或肠道感染。单因素分析提示APACHEⅡ评分,SOFA评分,存在感染性休克、肺部感染、血行感染,乳酸值影响患者预后。多因素Logistic回归分析显示APACHEⅡ评分、是否存在血行感染是AKI的死亡危险因素。结论 APACHEⅡ评分、是否存在血行感染可以作为SI-AKI预后的重要依据。Objective To investigate the clinical characteristics and prognostic factors of sepsis-induced acute kidney injury（SI-AKI）. Methods 137 patients with sepsis-induced AKI were included in the study. The clinical characteristics and prognostic factors were analyzed retrospectively. Results Patients with SI-AKI had higher APACHEII scores,higher SOFA scores,higher lactate,higher mortality compared with those with non-septic-induced AKI,the difference was statistically significant. Most SI-AKI patients suffered from AKI at stage 3,and the main causes of sepsis-induced AKI included pulmonary and intestinal infection. Univariate analysis showed that the prognostic factors of AKI included the APACHEII score,SOFA score,septic shock,pulmonary infection,bloodstream infection and lactate. The multivariable logistic regression revealed that SOFA score,bloodstream infection were the independent risk factors of mortality in patients with SI-AKI. Conclusion SOFA score and bloodstream infection can influence on prognosis of patients with SI-AKI.

关 键 词：脓毒症相关性急性肾损伤 APACHEⅡ评分 SOFA评分 乳酸 预后 

分 类 号：R692.5[医药卫生—泌尿科学]