重症患者发生万古霉素相关急性肾损伤的危险因素分析  

Analysis of risk factors for vancomycin-induced acute kidney injury in ICU patients

作　　者：李雪雪 周树生 张雨晨 孟华东 潘孝东 LI Xuexue;ZHOU Shusheng;ZHANG Yuchen;MENG Huadong;PAN Xiaodong(Provincial Hospital Affiliated to Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学附属省立医院,合肥230000

出　　处：《山东医药》2019年第3期22-25,共4页Shandong Medical Journal

基　　金：安徽省自然科学基金资助项目(1608085MH214)

摘　　要：目的探讨重症患者发生万古霉素相关急性肾损伤(VI-AKI)的危险因素。方法 58例重症患者根据是否发生VI-AKI分为AKI者13例(AKI组)和没有发生AKI者45例(非AKI组),采用单因素分析法比较两组临床资料,多因素Logistic回归分析法分析重症患者发生VI-AKI的危险因素。结果与非AKI组比较,AKI组高尿酸血症及联合应用利尿剂、血管活性药物比率高,血清白蛋白水平低(P均<0.05);多因素Logistic回归分析显示,高尿酸血症及联合应用利尿剂是发生AKI的独立危险因素,血清白蛋白水平是AKI的独立保护因素。结论高尿酸血症及联合应用利尿剂是重症患者发生VI-AKI的独立危险因素,血清白蛋白水平其独立保护因素。Objective To investigate the risk factors of vancomycin-induced acute kidney injury(VI-AKI)in intensive care unit(ICU)patients.Methods Fifty-eight patients were enrolled and then were divided into the AKI group(13 patients with AKI)and NO-AKI group(45 patients without AKI).The clinical data of the two groups were compared by univariate analysis.Multiple logistic regression analysis was used to analyze the risk factors of VI-AKI in ICU patients.Results Compared with the NO-AKI group,AKI group had hyperuricemia,a higher ratio of using diuretic and vasoactive drugs,and lower serum albumin level(all P<0.05).Multiple logistic regression analysis showed that hyperuricemia and diuretics were independent risk factors for VI-AKI,and serum albumin was known as an independent protective factor for VI-AKI.Conclusion Hyperuricemia and the combined diuretics are independent risk factors for VI-AKI in severe patients,and serum albumin is an independent protective factor.

关 键 词：万古霉素 急性肾损伤 重症患者 高尿酸血症 利尿剂 白蛋白 

分 类 号：R692[医药卫生—泌尿科学]