连续性肾脏替代治疗时机对肺结核合并急性肾损伤的效果评价  

Evaluation of Continuous Renal Replacement Therapy Timing for Pulmonary Tuberculosis Complicated With Acute Renal Injury

作　　者：贺德刚[1] 许秀华 白培进 杨晓萍[2] 林志君[3] 周荣[4] HE Degang;XU Xiuhua;BAI Peijin;YANG Xiaoping;LIN Zhijun;ZHOU Rong(Department of Nephrology,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361000,China;Department of Nephrology,The First Affiliated Hospital of School of Medicine,Shihezi University,Shihezi Xinjiang 832000,China;Department of Pulmonary,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361000,China;Department of Cadre Health Special Diagnosis,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361000,China)

机构地区：[1]厦门大学附属第一医院肾内科,福建厦门361000 [2]石河子大学医学院第一附属医院肾内科,新疆石河子832000 [3]厦门大学附属第一医院肺科,福建厦门361000 [4]厦门大学附属第一医院干部保健特诊部,福建厦门361000

出　　处：《中国卫生标准管理》2022年第17期46-51,共6页China Health Standard Management

基　　金：国家自然科学基金项目(81160090)。

摘　　要：目的探讨连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)不同介入时机治疗肺结核合并急性肾损伤(acute kidney injury,AKI)患者的临床疗效及预后。方法回顾性分析2017年5月—2020年12月笔者所在医院收治的肺结核合并急性肾损伤患者68例,参照改善全球肾脏病预后组织(kidney disease:improving the global outcome,KDIGO)的AKI诊断指南将患者分为早期组和晚期组,进行CRRT治疗。比较两组治疗前后肾功能指标、炎症指标、疾病严重程度评分和肾功能恢复时间及28 d病死率。结果治疗5 d后早期组肾功能指标低于晚期组,差异有统计学意义(P<0.05)。两组患者的炎症指标、入住ICU时长、呼吸机支持时间与血管活性药物使用时间、疾病严重程度评分、28d病死率比较,差异无统计学意义(P>0.05)。两组患者的住院总时长、CRRT替代时长、肾功能恢复时间比较,差异有统计学意义(P<0.05)。结论对于肺结核合并AKI患者,早期CRRT介入有利于改善患者的整体预后。Objective To investigate the clinical efficacy and prognosis of continuous renal replacement therapy(CRRT)at different times of intervention in the treatment of patients with pulmonary tuberculosis complicated with acute kidney injury(AKI).Methods A retrospective analysis was performed on 68 patients with pulmonary tuberculosis complicated with AKI admitted to the hospital between May 2017 and December 2020.According to the AKI diagnostic guidelines of kidney disease:improving the global outcome(KDIGO),patients were divided into the early group and the late group for CRRT treatment.The renal function indexes,inflammatory indexes,disease severity score,renal function recovery time and 28-day mortality were compared between the two groups before and after treatment.Results After 5 days of treatment,the renal function indexes of the early group were lower than those of the late group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in inflammatory indexes,length of stay in ICU,time of ventilator support and use of vasoactive drugs,disease severity score and 28-day mortality between the two groups(P>0.05).There were statistically significant differences in the total length of hospital stay,CRRT replacement time,and renal function recovery time between the two groups(P<0.05).Conclusion For patients with pulmonary tuberculosis complicated with AKI,early CRRT intervention is conducive to improve the overall prognosis of patients.

关 键 词：连续性肾脏替代治疗 介入时机 肺结核 急性肾损伤 时间 预后 

分 类 号：R459[医药卫生—治疗学]