中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
3期
174-177
,共4页
何敏%李素华%桑晓红%刘健
何敏%李素華%桑曉紅%劉健
하민%리소화%상효홍%류건
软组织损伤%肾功能不全,急性%发生率%危险因素
軟組織損傷%腎功能不全,急性%髮生率%危險因素
연조직손상%신공능불전,급성%발생솔%위험인소
Soft tissue injuries%Renal insufficiency,acute%Incidence%Risk factor
目的 了解多发软组织损伤患者中急性肾损伤(AKI)的发生情况,筛选与AKI发生相关的临床危险因素.方法 选择2008年1月1日至2013年1月1日新疆医科大学第一附属医院513例诊断为多发软组织损伤且资料完整的住院患者.收集患者的人口统计学资料、AKI发生前后的临床资料和实验室检查结果,回顾性分析多发软组织损伤后AKI发生相关的独立危险因素.结果 513例患者的年龄为31(12 ～78)岁,男女比例为2.1∶1.其中74例发生AKI,发生率为14.4％.殴打伤患者中无AKI发生,车祸伤患者中发生27例(36.5％),其他原因损伤4例(5.4％).损伤面积＜1％的患者中发生AKI为1例(1.4％),损伤面积1％～＜3％的患者中发生AKI为4例(5.4％),损伤面积3％ ～5％的患者中发生AKI为10例(13.5％),损伤面积＞5％的患者中发生AKI为19例(25.7％),各组差异有统计学意义(P＜0.01).伴有慢性肾脏病患者AKI的发生率显著高于不伴有慢性肾脏病的患者(54.5％比20.3％,P＜0.01).74例AKI患者中死亡2例,病死率为2.7％.多因素logistic回归分析显示,年龄(OR=1.996)、基础血肌酐(SCr)水平(OR =0.976)、基础估算的肾小球滤过率(eGFR)(OR=0.964)、血钾(OR=2.117)、肌红蛋白(OR=0.950)、损伤面积(OR=1.811)是多发软组织损伤患者发生AKI的独立危险因素.结论 多发软组织损伤患者中AKI的发病率较高.年龄、基础SCr、基础eGFR、血钾、肌红蛋白、损伤面积是多发软组织损伤患者发生AKI的独立危险因素.
目的 瞭解多髮軟組織損傷患者中急性腎損傷(AKI)的髮生情況,篩選與AKI髮生相關的臨床危險因素.方法 選擇2008年1月1日至2013年1月1日新疆醫科大學第一附屬醫院513例診斷為多髮軟組織損傷且資料完整的住院患者.收集患者的人口統計學資料、AKI髮生前後的臨床資料和實驗室檢查結果,迴顧性分析多髮軟組織損傷後AKI髮生相關的獨立危險因素.結果 513例患者的年齡為31(12 ～78)歲,男女比例為2.1∶1.其中74例髮生AKI,髮生率為14.4％.毆打傷患者中無AKI髮生,車禍傷患者中髮生27例(36.5％),其他原因損傷4例(5.4％).損傷麵積＜1％的患者中髮生AKI為1例(1.4％),損傷麵積1％～＜3％的患者中髮生AKI為4例(5.4％),損傷麵積3％ ～5％的患者中髮生AKI為10例(13.5％),損傷麵積＞5％的患者中髮生AKI為19例(25.7％),各組差異有統計學意義(P＜0.01).伴有慢性腎髒病患者AKI的髮生率顯著高于不伴有慢性腎髒病的患者(54.5％比20.3％,P＜0.01).74例AKI患者中死亡2例,病死率為2.7％.多因素logistic迴歸分析顯示,年齡(OR=1.996)、基礎血肌酐(SCr)水平(OR =0.976)、基礎估算的腎小毬濾過率(eGFR)(OR=0.964)、血鉀(OR=2.117)、肌紅蛋白(OR=0.950)、損傷麵積(OR=1.811)是多髮軟組織損傷患者髮生AKI的獨立危險因素.結論 多髮軟組織損傷患者中AKI的髮病率較高.年齡、基礎SCr、基礎eGFR、血鉀、肌紅蛋白、損傷麵積是多髮軟組織損傷患者髮生AKI的獨立危險因素.
목적 료해다발연조직손상환자중급성신손상(AKI)적발생정황,사선여AKI발생상관적림상위험인소.방법 선택2008년1월1일지2013년1월1일신강의과대학제일부속의원513례진단위다발연조직손상차자료완정적주원환자.수집환자적인구통계학자료、AKI발생전후적림상자료화실험실검사결과,회고성분석다발연조직손상후AKI발생상관적독립위험인소.결과 513례환자적년령위31(12 ～78)세,남녀비례위2.1∶1.기중74례발생AKI,발생솔위14.4％.구타상환자중무AKI발생,차화상환자중발생27례(36.5％),기타원인손상4례(5.4％).손상면적＜1％적환자중발생AKI위1례(1.4％),손상면적1％～＜3％적환자중발생AKI위4례(5.4％),손상면적3％ ～5％적환자중발생AKI위10례(13.5％),손상면적＞5％적환자중발생AKI위19례(25.7％),각조차이유통계학의의(P＜0.01).반유만성신장병환자AKI적발생솔현저고우불반유만성신장병적환자(54.5％비20.3％,P＜0.01).74례AKI환자중사망2례,병사솔위2.7％.다인소logistic회귀분석현시,년령(OR=1.996)、기출혈기항(SCr)수평(OR =0.976)、기출고산적신소구려과솔(eGFR)(OR=0.964)、혈갑(OR=2.117)、기홍단백(OR=0.950)、손상면적(OR=1.811)시다발연조직손상환자발생AKI적독립위험인소.결론 다발연조직손상환자중AKI적발병솔교고.년령、기출SCr、기출eGFR、혈갑、기홍단백、손상면적시다발연조직손상환자발생AKI적독립위험인소.
Objective To investigate the incidence and risk factors of acute kidney injury (AKI) in patients with multiple soft tissue contusion.Methods A total of 513 patients diagnosed as multiple soft tissue contusion in the First Affiliated Hospital of Xinjiang Medical University from January 1,2008 to January 1,2013 were retrospectively analyzed.Demographics,clinical data and laboratory examinations before and after AKI were collected and analyzed.Results The age of all subjects was 31.30 (12-78) years old with the male to female ratio of 2.1∶ 1.AKI occurred in 74 cases with an incidence rate of 14.4％.No AKI was observed in patients with assault injuries,while AKI was found in 27 cases (36.5％) with car accident injuries and 4 cases (5.4％) with other injuries.AKI showed in 1 case(1.4％) with damaged area under 1％,in 4 cases(5.4％) with damaged area ranged from 1％ to ＜ 3％,10 cases (13.5％) with damaged area ranged from 3％ to 5％ and 19 cases (25.7％) with damaged area over 5％ with significant difference among the groups (P ＜ 0.01).Incidence rate of AKI was significantly higher in patients with chronic kidney disease (CKD) than those without CKD (54.5％ vs 20.3％,P ＜ 0.01).Two of the AKI cases died,with a mortality rate of 2.7％.Multivariate logistic regression analysis showed that the followings were the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injuries:age (OR =1.996),basic serum creatinine (OR =0.976),basic evaluated GFR (eGFR) (OR =0.964),serum potassium (OR =2.117),myoglobin (OR =0.950) and damaged area (OR =1.811).Conclusions Incidence rate of AKI is quite high in multiple soft tissue contusion.Age,basic serum creatinine,basic eGFR,serum potassium,myoglobin and damaged area are the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injury.
