摘要
目的探讨分析急性脑血管病(ACVD)病人并发急性肾损伤(AKI)的相关因素及预防、干预的有效措施,为临床上及早诊断并合理地制定和调整相应预防和治疗措施提供一定的参考。方法收集入院时无AKI的ACVD病人126例,监测肾功能、离子、尿常规及尿量等相关项目,观察治疗结果和预后情况。入选病人分为观察组(并发AKI组)和对照组(未并发AKI组),对两组病人的相关临床资料进行比较分析。结果 ACVD并发AKI的发病率为41/126(32.54%),其中脑出血并发AKI者29例,占全部并发AKI病例数的70.73%;脑梗死并发AKI者12例,占29.27%。观察组死亡率24.39%,其中脑出血7例,大面积脑梗死3例;对照组死亡率5.88%,其中脑出血4例,脑梗死1例。观察组死亡率明显高于对照组。观察组老年(≥60岁),存在高血压、糖尿病、高脂血症等基础疾病,脑出血,病变位于丘脑,病变范围大,使用相关肾毒性药物病人的比率均高于对照组。结论 ACVD病人可并发AKI,尤其是在脑出血病例中易发生。ACVD并发AKI对病人的预后产生不利影响,死亡率明显升高。ACVD并发AKI不但与性别、年龄和原有基础疾病有关,而且与脑部病变的性质、部位、严重程度以及应用肾毒性药物的剂量和种类等因素密切相关。临床上需要重视上述诸项相关因素,予密切监测和及时有效干预,避免AKI的发生。
Objective To discuss and analyse the relative factors,effective preventions and interventions of acute cerebrovascular disease（ACVD） complicated by acute kidney injury（AKI）,in order to provide referrence on early detection and proper treatment of the patient of ACVD complicated by AKI in clinical.Methods Collected 126 cases of patients with ACVD but without AKI before hospitalized to the emergency room or clinic room of our hospital in the past tow years.Tested renal function,serum ions,urine routine and other ralated tests,monitored urine volumand,observe the treatment results and prognosis.The selected patients was divided into two groups：study group（concurrent AKI group） and the control group（non-concurrent AKI group）,and then analysed and compared the clinical data of the patients in the two groups.Results The morbility of the ACVD complicated by AKI group was（41/126）32.54%,in which the number of the cerebral hemorrhage with AKI was 29,accounting 70.73% of the total,the number of cerebral infarction with AKI was 12,accounting 29.27% of the total.The death rate of the study group was 24.39%,7 cases died of cerebral hemorrhage,3 cases deid of massive cerebral infarction;The death rate of the contrast group was 5.88%,4 cases died of cerebral hemorrhage,1 cases deid of cerebral infraction.The death rate of the study group was higher than the contrast group.The rates of the old（≥60 years）patients,being accompanied by hypertension,diabetes,hyperlipidemia,cerebral hemorrhage,the brain lesion located in thalamus,big lesion and using large dose mannitoland cephalosporin or aminoglycoside antibiotics of the study group were was higher than the contrast group.Conclusion Patients with ACVD were prone to complicated by AKI,especially in the cases of cerebral hemorrhage.The mortality of the patient with ACVD complicated by AKI was significantly higher than the patient not complicated with AKI,and the former group had a poor prognosis.The occurrence of ACVD complicated by AKI were not only related to gender,age and primary existing disease,but also associated with the other factors,such as the nature of the brain lesion,location,the severity of the brain lesiona and the use of nephrotoxicity.It＇s neccesary to attach importance to the above-mentioned factors in clinical ralated to ACVD complicated by AKI,and to give closely monitoring and effective intervention to prevent the occurrence of AKI.
出处
《中国实验诊断学》
北大核心
2011年第4期688-690,共3页
Chinese Journal of Laboratory Diagnosis
关键词
急性脑血管病
急性肾损伤
相关因素
acute cerebrovascular disease（ACVD）
acute kidney injury（AKI）
relative factor
