摘要
目的探讨感染性休克伴急性肾损伤的危险因素及其预后相关因素。方法选取2012年1月1日-2015年12月31日该院收治的感染性休克伴急性肾损伤患者60例作为观察组,感染性休克不伴急性肾损伤患者60例作为对照组,观察组分为死亡组14例和存活组46例。收集患者的临床资料进行比较。结果单因素分析结果显示,观察组与对照组应用造影剂、输血史、升血压药≥2种、肾小球滤过率、中心静脉压、急性生理学与慢性健康状况(APACHEⅡ)评分、血小板、血尿素氮、血p H值、C反应蛋白比较,差异有统计学意义(P<0.05);多因素分析结果显示,输血史[O~^R=5.431(95%CI:1.892,13.265)]、肾小球滤过率[O~^R=0.965(95%CI:0.784,0.985)]、APACHEⅡ评分[O~^R=3.896(95%CI:1.576,9.784)]为感染性休克伴急性肾损伤的独立危险因素(P<0.05)。单因素分析结果显示,死亡组与存活组高血压、糖尿病、机械通气、血管紧张素转化酶抑制剂(ACEI)药物、升压药≥2种、白蛋白、血p H值、C反应蛋白比较,差异有统计学意义(P<0.05);多因素分析结果显示,机械通气[O~^R=3.224(95%CI:1.187,7.856)]、升压药≥2种[O~^R=5.365(95%CI:1.535,16.758)]、白蛋白水平[O~^R=2.904(95%CI:1.102,6.869)]为影响感染性休克伴急性肾损伤预后的独立影响因素(P<0.05)。结论输血史、肾小球滤过率、APACHEⅡ评分为感染性休克伴急性肾损伤的独立危险因素,机械通气、ACEI药物、升压药≥2种、白蛋白水平为影响感染性休克伴急性肾损伤预后的独立影响因素。
Objective To investigate the risk factors and the prognostic factors of septic shock with acute renal injury. Methods Sixty patients of septic shock with acute renal injury were selected as observation group, 60 cases of septic shock without acute renal injury were selected as control group in Taizhou Central Hospital from January 2012 to December 2015. The observation group was further divided into death group （14 cases） and survival group （46 cases）. The clinical data were collected. Results Univariate analysis showed that the application of contrast agent, blood transfusion history, booster drugs ≥2 types, glomerular filtration rate, central venous pressure, APACHE Ⅱ score, platelets, blood urea nitrogen, blood pH value and C-reactive protein were significantly different between the observation group and the control group （P〈0.05）. Multivariate analysis showed that the history of blood transfusion [ O^R = 5.431 （95% CI： 1.892, 13.265）], glomerular filtration rate [O^R=0.965 （95%CI： 0.784, 0.985）], APACHE Ⅱ score [O^R=3.896 （95%CI： 1.576,9.784）] were the independent risk factors for septic shock with acute renal injury （P〈0.05）. Univariate analysis showed that there were significant differences in hypertension, diabetes mellitus, mechanical ventilation, ACEI drug, booster drugs ≥2 types, albumin, blood pH value and C-reactive protein between the death group and the survival group （P〈0.05）. Multivariate analysis showed that mechanical ventilation [ O^R =3.224 （95%CI：1.187, 7.856）], booster drugs ≥2 types [O^R=5.365 （95%CI： 1.535, 16.758）], albumin level [O^R=2.904 （95% CI： 1.102, 6.869）] were the independent prognostic impact factors for the infectious shock with acute renal injury （P〈0.05）. Conclusions The history of blood transfusion, glomerular filtration rate, APACHE Ⅱ score are the independent risk factors for septic shock with acute renal injury. Mechanical ventilation, ACEI drugs, booster drugs ≥2 types and albumin level are the independent prognostic impact factors for the infectious shock with acute renal injury.
出处
《中国现代医学杂志》
CAS
北大核心
2017年第17期98-102,共5页
China Journal of Modern Medicine
基金
2015年浙江省医药卫生一般研究计划(No:2015KYA234)
关键词
感染性休克
急性
肾损伤
危险因素
预后
infectious shock
acute
renal injury
risk factor
prognosis
