ICU急性肾损伤患者预后影响因素分析  

Analysis of prognostic factors in patients with acute kidney injury in ICU

作　　者：谭永峰[1] 冯星火[1] TAN Yongfeng;FENG Xinghuo(Department of Critical Medicine,Liaoning Provincial People's Hospital,Shenyang110016,China)

机构地区：[1]辽宁省人民医院重症医学科,辽宁沈阳110016

出　　处：《中国现代医生》2020年第7期97-100,共4页China Modern Doctor

摘　　要：目的观察ICU急性肾损伤患者120例预后影响因素分析。方法将我院ICU 2017年9月~2019年9月收治的ICU急性肾损伤者120例,依据患者的预后情况分为存活组73例与死亡组47例,分析其影响患者预后的因素。结果存活组患者患有高血压、冠心病史与糖尿病史的基础疾病比例低于死亡组患者(P<0.05)。而存活组患者APACHEⅡ评分、CRP、GFR指标水平低于死亡组患者,而SPO2、血pH值指标水平高于死亡组(P<0.05)。而存活组患者脓毒血症休克、有创血液检测、ICU内感染率与机械通气时间低于死亡组,而成功撤机率则高于死亡组患者(P<0.05)。存活、死亡分别作为因变量,基础疾病、APACHEⅡ评分、CRP、GFR、SPO2、血pH值、脓毒血症休克、有创血液检测、ICU内感染、成功撤机作为自变量,进行条件Logistics回归分析,结果发现,APACHEⅡ评分、脓毒血症休克、是否成功撤机为影响AKI患者预后的影响因素。结论在影响ICU急性肾损伤患者预后的相关因素中,患有基础疾病、APACHEⅡ评分、CRP、GFR、SPO2、血pH值、脓毒血症休克、有创血液检测、ICU内感染、成功撤机均为影响因素,其中以APACHEⅡ评分、脓毒血症休克、是否成功撤机为独立影响因素。Objective To observe the prognostic factors of 120 patients with acute kidney injury(AKI)in intensive care unit(ICU).Methods 120 AKI patients admitted in ICU of our hospital form September 2017 to September 2019 were divided into survival group(n=73)and death group(n=47)according to the prognosis of the patients,and the factors influencing the prognosis of the patients were analyzed.Results The proportion of underlying diseases in survival group was lower than that in death group(P<0.05).The APACHEⅡscore,CRP and GFR in the survival group were lower than those in the death group,while the SpO2 and blood pH were higher than those in the death group(P<0.05).Septic shock,invasive blood test,infection rate in ICU and mechanical ventilation time in the survival group were lower than those in the death group,while the rate of successful weaning was higher than that in the death group(P<0.05).Conditional Logistic regression analysis was conducted using survival and death as dependent variables,and underlying diseases,APACHEⅡscore,CRP,GFR,SpO2,pH value,septic shock,invasive blood test,infection in ICU and successful weaning as independent variables.The results showed that APACHEⅡscore,septic shock and successful weaning were the factors influencing the prognosis of AKI patients.Conclusion Among the factors influencing the prognosis of the AKI patients in ICU,underlying diseases,APACHEⅡscore,CRP,GFR,SpO2,blood pH value,septic shock,invasive blood test,infection in ICU and successful weaning are all the factors,among which APACHEⅡscore,septic shock and successful weaning are the independent factors.

关 键 词：ICU 急性肾损伤 预后 影响因素 

分 类 号：R641[医药卫生—外科学]