急性肾损伤患者连续性肾脏替代治疗预后的影响因素分析  

Prognostic factors of continuous renal replacement therapy in patients with acute kidney injury

作　　者：李爱琴[1] 张娓[1] 张文源[1] 陈建萍[1] LI Aiqin;ZHANG Wei;ZHANG Wenyuan;CHEN Jianping(Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province,Linhai 317000,China)

机构地区：[1]浙江省台州医院重症医学科,浙江临海317000

出　　处：《中国现代医生》2023年第4期12-15,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY769)。

摘　　要：目的探讨急性肾损伤患者连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)预后的影响因素。方法回顾性分析2018年6月至2020年6月于浙江省台州医院治疗的124例急性肾损伤患者的临床资料。根据患者预后将其分为存活组(n=91)和死亡组(n=33)。采用单因素及多因素分析影响急性肾损伤患者CRRT预后的相关因素。结果单因素分析结果显示,年龄>80岁、尿素清除率<60%、血尿素氮(blood urea nitrogen,BUN)>21.42mmol/L、血肌酐>442.00μmol/L、24h尿蛋白>2.0g/24h、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chroni chealth evaluationⅡ,APACHEⅡ)评分≥15分、衰竭器官个数≥3个、CRRT治疗时机为3期的患者病死率更高,差异均有统计学意义(P<0.05)。多因素分析结果显示,BUN水平、APACHEⅡ评分、衰竭器官个数、CRRT治疗时机、24h尿蛋白均是急性肾损伤患者CRRT不良预后的危险因素,尿素清除率是预后的保护因素(P<0.05)。结论急性肾损伤患者CRRT预后受多种因素影响,越早开展CRRT的患者预后越好。Objective To discuss the prognostic factors of continuous renal replacement therapy(CRRT)in patients with acute kidney injury.Methods The clinical data of 124 patients with acute kidney injury treated in Taizhou Hospital of Zhejiang Province from June 2018 to June 2020 were retrospectively analyzed.According to the prognosis,the patients were divided into survival group(n=91)and death group(n=33).Univariate and multivariate analysis were performed to determine the prognostic factors of CRRT in patients with acute kidney injury.Results Univariate analysis showed that the mortality of patients with age>80 years old,urea clearance rate<60%,blood urea nitrogen(BUN)>21.42 mmol/L,serum creatinine>442.00μmol/L,24h urinary protein>2.0g/24h,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score≥15,the number of failing organs≥3,CRRT treatment time stage 3 was higher,the difference was statistically significant(P<0.05).The results of multivariate analysis showed that BUN level,APACHEⅡscore,the number of failing organs,CRRT treatment timing,24h urine protein were all risk factors for poor prognosis in patients with acute kidney injury,and urea clearance rate was a protective factor for prognosis(P<0.05).Conclusion The prognosis of acute kidney injury patients with CRRT is affected by a variety of factors,and the earlier the onset of CRRT,the better the prognosis.

关 键 词：急性肾损伤 连续性肾脏替代治疗 预后 影响因素 

分 类 号：R692[医药卫生—泌尿科学]