CAJ | 학술논문

目的分析老年慢性肾脏病基础上急性肾损伤(A/C)的基础疾病、发病诱因及影响预后的危险因素.方法回顾性分析2005年12月至2009年12月于本院住院治疗的65例老年A/C患者的临床资料,分析A/C患者的基础疾病、发病诱因及影响预后的危险因素.根据治疗后肾功能恢复情况将患者分为2组:肾功能恢复患者和肾功能部分恢复患者合并为肾功能恢复组,肾功能未恢复患者与死亡患者合并为肾功能未恢复组,比较两组患者的少尿持续时间、入院时血清白蛋白水平和最高血清肌酐(Scr)水平.结果糖尿病肾病是老年A/C患者的主要基础疾病(38.5％,25/65),药物因素(30.8％,20/65)和严重感染(27.7％,l8/65)是老年A/C患者的主要发病诱因.与肾功能恢复组比较,肾功能未恢复组患者少尿持续时间较长[(1 1.5±3.4)d比(4.2±1.8)d,P＜0.05]、入院时血清白蛋白水平较低[(23.6±3.1)g/L比(26.6± 4.5) g/L,P＜0.05],而最高Scr水平较高[(601.2± 142.7) μmol/L比(421.3±107.3) μmol/L,P＜0.05].结论老年A/C患者应对其基础疾病进行有效治疗,积极消除发痫诱因和控制影响预后的危险因素.
목적 분석노년만성신장병기출상급성신손상(A/C)적기출질병、발병유인급영향예후적위험인소.방법 회고성분석2005년12월지2009년12월우본원주원치료적65례노년A/C환자적림상자료,분석A/C환자적기출질병、발병유인급영향예후적위험인소.근거치료후신공능회복정황장환자분위2조:신공능회복환자화신공능부분회복환자합병위신공능회복조,신공능미회복환자여사망환자합병위신공능미회복조,비교량조환자적소뇨지속시간、입원시혈청백단백수평화최고혈청기항(Scr)수평.결과 당뇨병신병시노년A/C환자적주요기출질병(38.5％,25/65),약물인소(30.8％,20/65)화엄중감염(27.7％,l8/65)시노년A/C환자적주요발병유인.여신공능회복조비교,신공능미회복조환자소뇨지속시간교장[(1 1.5±3.4)d비(4.2±1.8)d,P＜0.05]、입원시혈청백단백수평교저[(23.6±3.1)g/L비(26.6± 4.5) g/L,P＜0.05],이최고Scr수평교고[(601.2± 142.7) μmol/L비(421.3±107.3) μmol/L,P＜0.05].결론 노년A/C환자응대기기출질병진행유효치료,적겁소제발간유인화공제영향예후적위험인소.
Objective To analyze the underlying diseases,predisposing factors of acute kidney injury (AKI) secondary to chronic kidney disease (CKD) (A/C) and its risk factors affecting the prognosis.Methods Between December 2005 and December 2009,the clinical data of 65 elderly A/C in-patients were retrospectively analyzed for their underlying diseases,predisposing factors and risk factors affecting the prognosis.According to the recovery of kidney function after treatment,the patients were divided into 2 groups,including kidnev function recovered group (combined by kidney function recovered patients and partially recovered patients) and kidnev function unrecovered group (combined by kidney function unrecovered patients and dead patients).Thereafter,the oliguria stage,the level of seralbumin on admission and the highest serum creatinine (Scr) level between the 2 groups were then compared.Results Diabetic nephropathy was the main underlying disease of elderly A/C patients(38.5％,25/65).Furthermore,the drug factor (30.8％,20/65) and severe infection (27.7％,18/65) were the main predisposing factors of elderly A/C patients.Compared with the kidney function recovered group,the kidney function unrecovered group had relatively longer oliguria stage[(11.5±3.4)d vs (4.2±1.8)d,P＜0.05],lower level of seralbumin on admission [(23.6±3.1)g/L vs (26.6±4.5)g/L,P＜0.05] and much higher level of the highest Scr[(601.2± 142.7) μ mol/Lvs (421.3±107.3)μmol/L,P＜0.05].Conclusion The effective treatment for underlying diseases should be performed on the elderly A/C patients so as to eliminate the predisposing factors and the risk factors affecting the prognosis.