中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2013年
9期
660-664
,共5页
赵郁虹%吉凯强%臧彬%李德天
趙鬱虹%吉凱彊%臧彬%李德天
조욱홍%길개강%장빈%리덕천
ICU%慢性肾脏病%危险因素
ICU%慢性腎髒病%危險因素
ICU%만성신장병%위험인소
ICU%Chronic kidney disease%Risk factor
目的 分析重症监护室(ICU)住院患者慢性肾脏病(CKD)的发病情况及临床特点,探讨影响其发生的危险因素.方法 回顾性分析2007年1月至2010年12月本院2281例ICU住院患者的临床及预后资料,排除住院期间死亡、原有CKD、资料不完整及失防者421例,其中资料完整并可配合随访的患者1860例.依据SCODRED(隐匿性肾病筛查)评分及CKD诊断标准分为CKD组与非CKD组,分析影响ICU住院患者发生CKD的危险因素.结果 CKD组与非CKD组患者间在年龄、妊娠、急性肾损伤(AKI)、肝功能受损等因素方面的差异有统计学意义(P ＜ 0.05).ICU住院患者CKD的年患病率为20％～30％,其发病情况有随时间延长而增多的趋势.影响CKD患者预后的因素有年龄、妊娠、AKI、APACHE-Ⅱ评分、有创诊疗、机械通气、器官衰竭及应用肾损害药物.结论 ICU住院患者CKD患病率高,患病人数随时间的延长而增加.年龄、APACHE-Ⅱ评分＞15、器官衰竭个数≥2、肾损害药物应用种类≥2、合并妊娠、合并AKI、有创诊疗项数≥3、机械通气是ICU住院患者发生CKD的独立危险因素.
目的 分析重癥鑑護室(ICU)住院患者慢性腎髒病(CKD)的髮病情況及臨床特點,探討影響其髮生的危險因素.方法 迴顧性分析2007年1月至2010年12月本院2281例ICU住院患者的臨床及預後資料,排除住院期間死亡、原有CKD、資料不完整及失防者421例,其中資料完整併可配閤隨訪的患者1860例.依據SCODRED(隱匿性腎病篩查)評分及CKD診斷標準分為CKD組與非CKD組,分析影響ICU住院患者髮生CKD的危險因素.結果 CKD組與非CKD組患者間在年齡、妊娠、急性腎損傷(AKI)、肝功能受損等因素方麵的差異有統計學意義(P ＜ 0.05).ICU住院患者CKD的年患病率為20％～30％,其髮病情況有隨時間延長而增多的趨勢.影響CKD患者預後的因素有年齡、妊娠、AKI、APACHE-Ⅱ評分、有創診療、機械通氣、器官衰竭及應用腎損害藥物.結論 ICU住院患者CKD患病率高,患病人數隨時間的延長而增加.年齡、APACHE-Ⅱ評分＞15、器官衰竭箇數≥2、腎損害藥物應用種類≥2、閤併妊娠、閤併AKI、有創診療項數≥3、機械通氣是ICU住院患者髮生CKD的獨立危險因素.
목적 분석중증감호실(ICU)주원환자만성신장병(CKD)적발병정황급림상특점,탐토영향기발생적위험인소.방법 회고성분석2007년1월지2010년12월본원2281례ICU주원환자적림상급예후자료,배제주원기간사망、원유CKD、자료불완정급실방자421례,기중자료완정병가배합수방적환자1860례.의거SCODRED(은닉성신병사사)평분급CKD진단표준분위CKD조여비CKD조,분석영향ICU주원환자발생CKD적위험인소.결과 CKD조여비CKD조환자간재년령、임신、급성신손상(AKI)、간공능수손등인소방면적차이유통계학의의(P ＜ 0.05).ICU주원환자CKD적년환병솔위20％～30％,기발병정황유수시간연장이증다적추세.영향CKD환자예후적인소유년령、임신、AKI、APACHE-Ⅱ평분、유창진료、궤계통기、기관쇠갈급응용신손해약물.결론 ICU주원환자CKD환병솔고,환병인수수시간적연장이증가.년령、APACHE-Ⅱ평분＞15、기관쇠갈개수≥2、신손해약물응용충류≥2、합병임신、합병AKI、유창진료항수≥3、궤계통기시ICU주원환자발생CKD적독립위험인소.
Objective To analyze the occurrence and clinical features of chronic kidney disease (CKD) in the ICU patients and identify the possible risk factors.Methods A retrospective study was performed in 2281 ICU patients enrolled from Shengjing hospital between January 2007 and December 2010,in which 1860 cases had complete data and were followed-up,the other 421 cases were excluded for the reasons of dying,suffering from CKD originally,lacking complete data and missing.The cases were divided into CKD and non-CKD groups according to SCODRED and CKD diagnosis standards.Assessment was performed to screen risk factors of CKD.Results There were obvious differences between CKD and non-CKD groups at age,pregnancy,AKI and liver function (P ＜0.05).The CKD's annual morbidity rate of ICU patients was 20％-30％,and the incidence showed an increasing trend with time.Age,pregnancy,AKI,APACHE-Ⅱ score,invasive diagnosis and treatment,mechanical ventilation,organ failure and kidney-hurt drugs were risk factors for CKD in the ICU patients.Conclusions The morbidity rate of CKD in the ICU patients is high,and the number of CKD patients show an increasing trend with time.Age,APACHE-Ⅱ score ＞ 15,the number of failed organs ≥2,the variety of kidney-hurt drug≥2,pregnancy,AKI,the number of invasive diagnosis and treatment≥3,mechanical ventilation are independent risk factors of CKD in the ICU patients.
