国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2014年
2期
208-212
,共5页
沈婕%邓蓉蓉%张丽丽%赵玉%王静
瀋婕%鄧蓉蓉%張麗麗%趙玉%王靜
침첩%산용용%장려려%조옥%왕정
肾疾病%慢性病
腎疾病%慢性病
신질병%만성병
Kidney Disease%Chronic Disease
目的 探讨慢性肾脏疾病(chronic kidney disease,CKD)急性加重(acute on chronic kidney disease,A/C)的相关因素及其预后并加以分析.方法 对2011年1月至2012年2月住院的A/C患者55例,按其基础疾病、加重因素、好转因素、治疗方式和预后进行回顾性总结.结果 A/C基础疾病以肾病综合征(27.3％)、慢性间质性肾炎(14.5％)、糖尿病肾病(14.5％)、高血压性肾病(10.9％)为主.A/C加重因素依次为感染(32.7％)、原发病加重(29.1％)、肾毒性药物(12.7％)、不规则使用激素及免疫抑制剂(5.5％)等,7例同时存在≥2种病因(12.7％).积极行透析及非透析治疗后住院期间肾功能好转者38例.随访时间7.6±4.4个月,其中随访44例,失访11例.随访期间肾功能正常或明显好转患者14例(31.8％)、肌酐倍增患者14例(31.8％)、终末期肾功能衰竭患者8例(18.2％)、死亡患者8例(18.2％),死亡原因主要为多脏器功能衰竭,其中5例为老年患者.结论 对于A/C加重因素多可逆,但远期预后不佳,应重视A/C发生的加重因素并及早发现,争取在最大程度改善肾功能,降低病死率,延长患者生命.
目的 探討慢性腎髒疾病(chronic kidney disease,CKD)急性加重(acute on chronic kidney disease,A/C)的相關因素及其預後併加以分析.方法 對2011年1月至2012年2月住院的A/C患者55例,按其基礎疾病、加重因素、好轉因素、治療方式和預後進行迴顧性總結.結果 A/C基礎疾病以腎病綜閤徵(27.3％)、慢性間質性腎炎(14.5％)、糖尿病腎病(14.5％)、高血壓性腎病(10.9％)為主.A/C加重因素依次為感染(32.7％)、原髮病加重(29.1％)、腎毒性藥物(12.7％)、不規則使用激素及免疫抑製劑(5.5％)等,7例同時存在≥2種病因(12.7％).積極行透析及非透析治療後住院期間腎功能好轉者38例.隨訪時間7.6±4.4箇月,其中隨訪44例,失訪11例.隨訪期間腎功能正常或明顯好轉患者14例(31.8％)、肌酐倍增患者14例(31.8％)、終末期腎功能衰竭患者8例(18.2％)、死亡患者8例(18.2％),死亡原因主要為多髒器功能衰竭,其中5例為老年患者.結論 對于A/C加重因素多可逆,但遠期預後不佳,應重視A/C髮生的加重因素併及早髮現,爭取在最大程度改善腎功能,降低病死率,延長患者生命.
목적 탐토만성신장질병(chronic kidney disease,CKD)급성가중(acute on chronic kidney disease,A/C)적상관인소급기예후병가이분석.방법 대2011년1월지2012년2월주원적A/C환자55례,안기기출질병、가중인소、호전인소、치료방식화예후진행회고성총결.결과 A/C기출질병이신병종합정(27.3％)、만성간질성신염(14.5％)、당뇨병신병(14.5％)、고혈압성신병(10.9％)위주.A/C가중인소의차위감염(32.7％)、원발병가중(29.1％)、신독성약물(12.7％)、불규칙사용격소급면역억제제(5.5％)등,7례동시존재≥2충병인(12.7％).적겁행투석급비투석치료후주원기간신공능호전자38례.수방시간7.6±4.4개월,기중수방44례,실방11례.수방기간신공능정상혹명현호전환자14례(31.8％)、기항배증환자14례(31.8％)、종말기신공능쇠갈환자8례(18.2％)、사망환자8례(18.2％),사망원인주요위다장기공능쇠갈,기중5례위노년환자.결론 대우A/C가중인소다가역,단원기예후불가,응중시A/C발생적가중인소병급조발현,쟁취재최대정도개선신공능,강저병사솔,연장환자생명.
Objectives To investigate and analyse the related factors of acute-on-chronic kidney diseases(A/C) and its prognosis.Methods Clinic data from all patients diagnosed as A/C for one year period(Jan,2011 to Feb,2012) were collected,and the underlying disease,factors of aggravation and improvement,therapy method and results of follow-up were summarized retrospectively.Results The underlying diseases of A/C were mainly nephrotic syndrome (27.3 ％)、Chronic Interstitial Nephritis (14.5 ％)、diabetic nephropathy (14.5 ％) and Hypertensive kidney disease(10.9％).The aggravated factors were infection(32.7％) 、aggravation of underlying diseases (29.1％) 、nephrotoxicity drug (12.7 ％) 、non-standard usage of hormone and immune inhibitor (5.5 ％),etc.Seven cases have more than 2 kinds of factors(12.7％).After positive dialysis treatment and non-dialysis treatment,the renal function improved in 38 cases while in hospital.The follow-up time were 7.6 ± 4.4 months,44 cases were follow-up,while 11 cases were lost.During the follow-up time,the renal function returned to normal level or markedly improved in 14 cases(31.8％),serum creatinine multiplication in 14 cases(31.8％),patients with end-stage renal failure were 8(18.2％),and 8 cases died(18.2％),the death cases were mainly multiple organ failure and 5 were elderly patient.Conclusions Most of the aggravated factors of A/C were reversible,but the long-term prognosis was poor,the aggravated factors should be paid high attention to and actively found out to strive for the maximum improvement of kidney function,reduce the case fatality rate and prolong patient's life time.
