病毒性肺炎相关性急性肾损伤的危险因素及预后分析  

Analysis of risk factors and prognosis of viral pneumonia-related acute kidney injury

作　　者：袁宏波 陈大伟 万辛[1] Yuan Hong-bo;Chen Da-wei;Wan Xin(Department of Nephrology,Affiliated Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院肾内科,南京210006

出　　处：《临床肾脏病杂志》2022年第1期10-15,共6页Journal Of Clinical Nephrology

摘　　要：目的探讨病毒性肺炎患者急性肾损伤(acute kidney injury,AKI)的发病率及其危险因素,分析病毒性肺炎患者院内死亡的危险因素。方法回顾性分析南京医科大学附属南京医院2014年1月至2019年12月病毒性肺炎患者的临床资料。采用二分类Logistic回归分析AKI的危险因素。采用Cox比例风险回归分析病毒性肺炎患者院内死亡的危险因素。结果本研究共纳入388例病毒性肺炎患者,其中32例(8.2%)发生了AKI,Logistic回归分析结果表明,病毒性肺炎患者发生AKI的危险因素包括:男性(OR=3.59,95%CI 1.20~10.75,P=0.022),入院时发生呼吸衰竭(OR=3.80,95%CI 1.40~10.28,P<0.001),高血压病(OR=3.29,95%CI 1.18~9.16,P=0.023),糖尿病(OR=2.92,95%CI 1.01~8.45,P=0.048),白细胞计数(OR=1.14,95%CI 1.03~1.26,P=0.013),C反应蛋白(OR=1.02,95%CI 1.01~1.02,P=0.001),血红蛋白(OR=0.97,95%CI 0.95~0.99,P=0.015)。Cox比例风险模型结果显示,病毒性肺炎患者院内死亡的危险因素包括:年龄(HR=1.07,95%CI 1.02~1.11,P=0.003),糖尿病(HR=3.52,95%CI 1.14~10.82,P=0.028),C反应蛋白(HR=1.01,95%CI 1.01~1.02,P<0.001),以及AKI(HR=4.1,95%CI 1.28~13.2,P=0.018)。AKI是病毒性肺炎患者院内死亡重要的独立危险因素。结论病毒性肺炎患者AKI的发病率较高,并且合并AKI的患者病死率也较高。AKI是病毒性肺炎患者院内死亡的独立危险因素。Objective To explore the incidence and risk factors of acute kidney injury(AKI)and examine the risk factors for in-hospital mortality in patients with viral pneumonia.Methods Between January 2014 and December 2019,retrospective analysis was performed for 388 patients with viral pneu⁃monia.Binary Logistic regression was employed for analyzing the risk factors for AKI.And Cox regres⁃sion analysis was performed for determining the variables influencing in-hospital mortality.Results Among them,AKI occurred(n=32,8.2%).Logistic regression analysis revealed that the risk factors of AKI included male(OR=3.59,95%CI 1.20-10.75,P=0.022),respiratory failure during admission(OR=3.80,95%CI 1.40-10.28,P<0.001),hypertension(OR=3.29,95%CI 1.18-9.16,P=0.023),diabetes mellitus(OR=2.92,95%CI 1.01-8.45,P=0.048),leucocyte count(OR=1.14,95%CI 1.03-1.26,P=0.013),C-reactive protein(OR=1.02,95%CI 1.01-1.02,P=0.001)and hemoglobin(OR=0.97,95%CI 0.95-0.99,P=0.015).Cox regression analysis indicated that the risk factors of in-hospital mortality included age(HR=1.07,95%CI 1.02-1.11,P=0.003),diabetes mellitus(HR=3.52,95%CI 1.14-10.82,P=0.028),C-reactive protein(HR=1.01,95%CI 1.01-1.02,P<0.001)and AKI(HR=4.1,95%CI 1.28-13.2,P=0.018).AKI was an important independent risk factor for in-hospital death.Conclusion AKI is common in patients with viral pneumonia and mortality rate remains high among this population.AKI is an independent risk factor for in-hospital death.

关 键 词：病毒性肺炎 急性肾损伤 院内死亡 

分 类 号：R563.1[医药卫生—呼吸系统] R692[医药卫生—内科学]