急性肾损伤患者连续性血液净化低磷血症发生情况及其对预后的影响  

Incidence of Hypophosphatemia After Continuous Blood Purification in Patients with Acute Kidney Injury and Its Impact on Prognosis

作　　者：张颖[1] 吴琼皎[1] 常玉萍 卫丹辉[1] 袁欢[1] ZHANG Ying;WU Qiongjiao;CHANG Yuping;WEI Danhui;YUAN Huan(Blood Purification Center,Sanmenxia Central Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中心医院血液净化中心,河南三门峡472000

出　　处：《河南医学研究》2025年第1期88-91,共4页Henan Medical Research

摘　　要：目的观察急性肾损伤(AKI)患者连续性血液净化(CBP)后低磷血症发生情况,并分析其对预后的影响。方法采用前瞻性研究,选择三门峡市中心医院各重症监护病房2019年6月至2022年6月收治的82例AKI患者为研究对象,设计一般资料调查表,于入院时对患者进行详细调查并统计。82例AKI患者入院后均接受CBP治疗,观察患者治疗48 h内低磷血症发生情况。对所有患者随访30 d,根据患者预后情况分为病死组和存活组,比较不同预后患者一般资料及血磷变化,使用点二列相关性分析血磷水平与预后的关系,并采用Cox回归分析血磷水平对患者预后的影响。结果CBP治疗48 h内,82例AKI患者中48例(58.54%)发生低磷血症。病死组与存活组性别、年龄、体重指数、合并基础疾病、长期饮酒史、长期吸烟史、急性肾损伤分期比较,差异无统计学意义(P>0.05);病死组急性生理与慢性健康评价(APACHE)Ⅱ评分、CBP治疗时长高于存活组,差异有统计学意义(P<0.05);病死组治疗结束时血磷水平低于存活组,差异有统计学意义(P<0.05);点二列分析结果显示,APACHEⅡ评分、CBP治疗时长与AKI患者预后不良呈正相关(r>0,P<0.05);血磷水平与AKI患者预后不良呈负相关(r<0,P<0.05);经Cox回归分析结果显示,APACHEⅡ评分高表达、CBP治疗时间长为AKI患者预后的危险因素(HR>1,P<0.05);治疗结束时血磷水平高为AKI患者预后的保护因素(HR<1,P<0.05)。结论AKI患者CBP治疗期间低磷血症的发生概率较高,且对患者预后会产生影响。Objective To observe the occurrence of hypophosphatemia in patients with acute kidney injury(AKI)after continuous blood purification(CBP),and analyze its impact on the prognosis.Methods A prospective study was conducted to select 82 patients with AKI who were admitted to all ICUs of Sanmenxia Central Hospital from June 2019 to June 2022 as the research objects.A general data questionnaire was designed and the patients were investigated and counted in detail at admission.Eighty-two patients with AKI were treated with CBP after admission,and the occurrence of hypophosphatemia within 48 hours after treatment was observed.All patients were followed up for 30 days,and were divided into dead group and survival group according to the prognosis of patients.The general data and blood phosphorus changes of patients with different prognosis were compared.The relationship between blood phosphorus level and prognosis was analyzed using point binary correlation,and the impact of blood phosphorus level on the prognosis of patients was analyzed using Cox regression.Results Forty-eight(58.54%)of 82 AKI patients developed hypophosphatemia within 48 hours after CBP treatment.There was no statistical significant difference in sex,age,body mass index,concomitant basic diseases,long-term drinking history,long-term smoking history,and acute renal injury stage between the death group and the survival group(P>0.05).The acute physiology and chronic health evaluation(APACHE)Ⅱscore and the duration of CBP treatment in the death group were higher than those in the survival group,with a statistical significant difference(P<0.05).The blood phosphorus level in the dead group was lower than that in the survival group at the end of treatment,with a statistical significant difference(P<0.05).Point binary analysis showed that APACHEⅡscore and CBP treatment duration were positively correlated with poor prognosis of AKI patients(r>0,P<0.05).The serum phosphorus level was negatively correlated with the poor prognosis of AKI patients(r<0,P<0.05).Co

关 键 词：急性肾损伤 连续性血液净化 低磷血症 血磷水平 预后 

分 类 号：R459.5[医药卫生—治疗学]