CAJ | 학술논문

目的：探讨急性脑血管疾病(ACVD)并急性肾损伤(AKI)的相关影响因素，为临床合理治疗ACVD，预防AKI的发生提供一定的理论依据。方法：应用医院网络信息系统筛选出2009年10月～2012年2月ACVD并AKI患者，回顾分析ACVD并AKI患者的发病率、并发症及相关检测指标，用Logistic回归分析ACVD并AKI的病因和相关因素。结果：ACVD并AKI的总发病率为10.28%，ACVD并AKI患者均合并1种或以上其他疾病，Logistic回归分析提示感染是AKI最常见的病因。单因素回归分析显示年龄、血肌酐(Scr)基础值、血尿素氮(BUN)基础值、二氧化碳结合力(CO2CP)基础值、Scr峰值、BUN峰值、血尿酸(UA)峰值、血清白蛋白(ALB)(P<0.05)是ACVD并发AKI的影响因素，进行多因素logistic逐步回归分析，得出Scr峰值是ACVD并AKI的最重要因素。结论：ACVD患者可并发AKI，尤其是在ICH患者中易发生。感染是ACVD并发AKI的常见病因，而年龄、Scr基础值、BUN基础值、CO2CP基础值、Scr峰值、BUN峰值、UA峰值、ALB是ACVD并AKI的有密切关系，临床上需要重视上述诸项相关因素。
목적：탐토급성뇌혈관질병(ACVD)병급성신손상(AKI)적상관영향인소，위림상합리치료ACVD，예방AKI적발생제공일정적이론의거。방법：응용의원망락신식계통사선출2009년10월～2012년2월ACVD병AKI환자，회고분석ACVD병AKI환자적발병솔、병발증급상관검측지표，용Logistic회귀분석ACVD병AKI적병인화상관인소。결과：ACVD병AKI적총발병솔위10.28%，ACVD병AKI환자균합병1충혹이상기타질병，Logistic회귀분석제시감염시AKI최상견적병인。단인소회귀분석현시년령、혈기항(Scr)기출치、혈뇨소담(BUN)기출치、이양화탄결합력(CO2CP)기출치、Scr봉치、BUN봉치、혈뇨산(UA)봉치、혈청백단백(ALB)(P<0.05)시ACVD병발AKI적영향인소，진행다인소logistic축보회귀분석，득출Scr봉치시ACVD병AKI적최중요인소。결론：ACVD환자가병발AKI，우기시재ICH환자중역발생。감염시ACVD병발AKI적상견병인，이년령、Scr기출치、BUN기출치、CO2CP기출치、Scr봉치、BUN봉치、UA봉치、ALB시ACVD병AKI적유밀절관계，림상상수요중시상술제항상관인소。
Objective To discuss and analyse the relative factors of acute cerebrovascular disease (ACVD) compli-cated 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 The patients of ACVD complicated by AKI in Affiliated Hospital of Shaoyang Medical College,during October 2009 to February 2012 were screened by Lab Administration Network. The incidence, Complications and related indexes of the patients of ACVD complicated by AKI were retrospectively ana-lyzed.Logistic regression analysis was used to investigate the etiology and relative factors in the patients of ACVD com-plicated by AKI. Results Forty-seven patients suffering from ACVD complicated by AKI were enrolled. The morbility of the ACVD complicated by AKI group was 10.28%, ACVD and AKI patients were merged or at least one disease, Logistic regression analysis showed that the most common reason of AKI was infection. Univariate analysis showed that age, the Serum creatinine(Scr) underlaying level, the blood urea anitrogen(BUN) underlaying level, the plasm carbon dioxide com-bining power (CO2CP) underlaying level, Scr peak level,BUN peak level,Serum uric acid peak level,Serum albumin were independent risk factors for ACVD complicated by AKI.Multivariate logistic regression analysis showed Scr peak level was the most important factor of ACVD complicated by AKI. Conclusion Patients with ACVD were prone to complicated by AKI, especially in the cases of intracerebral hemorrhage. infection was the most common reason of the ACVD compli-cated by AKI. The occurrence of ACVD complicated by AKI were closely related to age, the Scr underlaying level,the BUN underlaying level, the Serum CO2CP underlaying level, Scr peak level,BUN peak level,Serum uric acid peak level, Serum albumin. It's necessary to attach importance to the above-mentioned factors in clinical ralated to ACVD compli-cated by AKI.