摘要
目的探讨脓毒症并发急性肾损伤(AKI)患者的临床特点及其影响预后的因素。方法回顾性分析2006年12月至2011年10月入住温州医科大学附属第一医院急诊重症监护室的脓毒症并发AKI患者90例。用单因素及多因素Logistic回归分析研究其临床特点及影响预后的危险因素。结果 90例脓毒症并发AKI患者的感染诱因主要为腹内感染、肺部感染、皮肤及软组织感染;AKI 2、3期病死率明显高于1期(P<0.05);32例患者接受了肾脏替代治疗,44例患者需机械通气支持,45例死亡(病死率为50.0%)。单因素分析提示器官衰竭数目、AKI分期、应用血管活性药物、是否需要机械通气支持都能影响患者预后(P均<0.05)。多因素Logistic回归分析显示,器官衰竭数目(P=0.008,OR=2.181)、AKI分期(P=0.011,OR=2.227)、是否需要机械通气支持(P=0.002,OR=0.198)是患者死亡的独立危险因素。结论器官衰竭数目、AKI分期及需机械通气支持可作为判断脓毒症并发AKI患者预后的重要依据。
Objective To investigate the clinical characteristics and prognostic factors of sepsis-induced acute kidney injury （AKI）. Methods Ninety patients with sepsis-induced AKI admitted to the First Affiliated Hospital of Wenzhou Medical University from December, 2006 to October, 2011 were included in the study. The clinical characteristics and prognostic factors were analyzed retrospectively by one variable analysis and multivariable Logistic regression analysis. Results The main causes of sepsis-induced AKI included intra-abdominal infection, pulmonary infection, skin and soft tissue infection. More patients with AKI at stage 2 or stage 3 died than those at stage l （P 〈 0.05）. Of all the patients, 32 cases received the renal replacement therapy, 44 cases required mechanical ventilatory support and 45 patients died with a mortality rate of 50.0%. Univariate analysis showed that the prognostic factors of AKI included the number of organ failure, AKT staging, application of vasoactive drugs and mechanical vendlatory support （all P 〈 0.05）. The multivariable logistic regression revealed that the number of organ failure （P = 0.008, OR = 2.181）, AKI staging （P = 0.011, OR = 2.227）and mechanical ventilatory support （P = 0.002, OR = 0.198） were the independent risk factors of mortality in patients with sepsis-induced AKI. Conclusion The number of organ failure, AKI staging and mechanical ventilatory support can influence the prognosis of patients with sepsis- induced AKI.
出处
《中华危重症医学杂志（电子版）》
CAS
2014年第1期30-34,共5页
Chinese Journal of Critical Care Medicine:Electronic Edition
基金
浙江省"十二五"高校重点学科
浙江省医学创新学科建设计划(11-CX26)
浙江省中医药重点学科建设计划(2012-XK-A28)
关键词
脓毒症
急性肾损伤
临床特点
预后
Sepsis
Acute kidney injury
Clinical characteristic
Prognosis
