中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2015年
6期
530-533
,共4页
社区获得性急性肾损伤(CA-AKI)%急诊%病因%预后
社區穫得性急性腎損傷(CA-AKI)%急診%病因%預後
사구획득성급성신손상(CA-AKI)%급진%병인%예후
Community acquired acute kidney injury( CA-AKI)%Emergency Department%Clinical features%Etiology%Prognosis
目的：探讨就诊于急诊室的社区获得性急性肾损伤（ community acquired acute kidney injury， CA－AKI）的发病及预后情况，寻找与预后相关的危险因素，为临床更好地认识和预防CA－AKI、改善预后提供临床依据。方法对2013－05－01～2014－08－31就诊于北京大学第一医院急诊科的161例CA－AKI患者的临床资料进行回顾性分析，调查其临床特点及转归情况，分析CA－AKI的危险因素。结果符合入选标准的CA－AKI患者共161例，男88例，女73例；青年组（≤34岁）38例，占23．6％；中年组（35～59岁）54例，占33．5％；老年组（≥60岁）69例，占42．9％。肾前性93例（占57．8％），病因以感染相关性疾病及心脑血管疾病多见；肾性47例（占29．2％），以药物及肾小球疾病多见；肾后性21例（占13．0％），以尿路结石多见。161例CA－AKI患者中有42例死亡。 Logistic回归分析显示，年龄、少尿和多脏器功能障碍综合征（ MODS）是CA－AKI患者死亡的独立危险因素。结论 CA－AKI可由多种病因所导致，其中最常见的是肾前性因素，患者预后与年龄、少尿及MODS密切相关。
目的：探討就診于急診室的社區穫得性急性腎損傷（ community acquired acute kidney injury， CA－AKI）的髮病及預後情況，尋找與預後相關的危險因素，為臨床更好地認識和預防CA－AKI、改善預後提供臨床依據。方法對2013－05－01～2014－08－31就診于北京大學第一醫院急診科的161例CA－AKI患者的臨床資料進行迴顧性分析，調查其臨床特點及轉歸情況，分析CA－AKI的危險因素。結果符閤入選標準的CA－AKI患者共161例，男88例，女73例；青年組（≤34歲）38例，佔23．6％；中年組（35～59歲）54例，佔33．5％；老年組（≥60歲）69例，佔42．9％。腎前性93例（佔57．8％），病因以感染相關性疾病及心腦血管疾病多見；腎性47例（佔29．2％），以藥物及腎小毬疾病多見；腎後性21例（佔13．0％），以尿路結石多見。161例CA－AKI患者中有42例死亡。 Logistic迴歸分析顯示，年齡、少尿和多髒器功能障礙綜閤徵（ MODS）是CA－AKI患者死亡的獨立危險因素。結論 CA－AKI可由多種病因所導緻，其中最常見的是腎前性因素，患者預後與年齡、少尿及MODS密切相關。
목적：탐토취진우급진실적사구획득성급성신손상（ community acquired acute kidney injury， CA－AKI）적발병급예후정황，심조여예후상관적위험인소，위림상경호지인식화예방CA－AKI、개선예후제공림상의거。방법대2013－05－01～2014－08－31취진우북경대학제일의원급진과적161례CA－AKI환자적림상자료진행회고성분석，조사기림상특점급전귀정황，분석CA－AKI적위험인소。결과부합입선표준적CA－AKI환자공161례，남88례，녀73례；청년조（≤34세）38례，점23．6％；중년조（35～59세）54례，점33．5％；노년조（≥60세）69례，점42．9％。신전성93례（점57．8％），병인이감염상관성질병급심뇌혈관질병다견；신성47례（점29．2％），이약물급신소구질병다견；신후성21례（점13．0％），이뇨로결석다견。161례CA－AKI환자중유42례사망。 Logistic회귀분석현시，년령、소뇨화다장기공능장애종합정（ MODS）시CA－AKI환자사망적독립위험인소。결론 CA－AKI가유다충병인소도치，기중최상견적시신전성인소，환자예후여년령、소뇨급MODS밀절상관。
Objective To analyze the etiology and risk factors of community acquired acute kidney injury ( CA -AKI ) in Emergency Department.Methods 161 patients with CA -AKI that visited our Emergency Department from May 2013 to Aug 2014 were enrolled in this retrospective study. Clinical data and laboratory test results were collected.The etiology of the patients and prognostic factors were analyzed.Results 161 patients (88 males and 73 females) were enrolled in this study.23.6%patients (38 cases) were less than 35 years old, 33.5%(54 cases) between 35 and 60 years old, and 42.9%(69 cases) over 60 years old.The major causes were pre-renal factors (57.8%, 93 cases). Infectious diseases, cardiovascular and cerebrovascular diseases were major causes of pre-renal CA-AKI.Drug and glomerulopathy were major causes of renal parenchymal CA-AKI.The major cause of post-renal AKI was urinary stone.Multivariate analysis showed that independent risk factors for death were age, MODS and oliguria.Conclusion The major causes of CA-AKI are pre-renal factors.The important risk factors of death in CA-AKI patients are age, MODS and oliguria.
