CAJ | 학술논문

目的探讨神经重症患者高钠血症与急性肾损伤(AKI)的相关性.方法选择2011年8月至2013年8月我院收入ICU的神经重症患者,符合入选标准并按排除标准选择住院的239例患者纳入分析.血清钠＞145 mmol/L定义为高钠血症,以血钠≤145 mmol/L为非高钠组,血钠＞145 mmol/L为高钠组.采用Pearson线性相关模型分析高钠血症与AKI的相关性.结果高钠组头部手术率、入院时血钠、血钠最高值、甘露醇总量、住院时间均高于非高钠组[63.3％ (31/62)与31.1％(59/177),(143.14±4.90) mmol/L与(140.16±2.90) mmol/L,(148.87±5.30) mmol/L与(141.81±2.90) mmol/L,(55.67±28.50)×250ml与(37.67±25.40) ×250ml,(57.48±43.30)d与(12.33±4.36)d],差异均有统计学意义(x2值或F值分别为17.58、29.68、239.89、18.59、15.66,P均＜0.05).研究人群总体AKI发生率为25.9％ (62/239),非高钠组AKI发生率20.5％(39/177),高钠组AKI发生率46.9％(23/62),高钠组人群AKI发生率明显高于非高钠组,差异有统计学意义(x2=14.145,P＜0.05);Pearson线性相关分析显示年龄、头部手术率、血钠最高值、甘露醇总量与AKI呈正相关(r值分别为0.458、0.273、0.260、0.490,P均＜0.05).结论神经重症患者中,高钠血症与AKI的发生呈正相关,高钠血症是AKI发生的危险因素.
목적 탐토신경중증환자고납혈증여급성신손상(AKI)적상관성.방법 선택2011년8월지2013년8월아원수입ICU적신경중증환자,부합입선표준병안배제표준선택주원적239례환자납입분석.혈청납＞145 mmol/L정의위고납혈증,이혈납≤145 mmol/L위비고납조,혈납＞145 mmol/L위고납조.채용Pearson선성상관모형분석고납혈증여AKI적상관성.결과 고납조두부수술솔、입원시혈납、혈납최고치、감로순총량、주원시간균고우비고납조[63.3％ (31/62)여31.1％(59/177),(143.14±4.90) mmol/L여(140.16±2.90) mmol/L,(148.87±5.30) mmol/L여(141.81±2.90) mmol/L,(55.67±28.50)×250ml여(37.67±25.40) ×250ml,(57.48±43.30)d여(12.33±4.36)d],차이균유통계학의의(x2치혹F치분별위17.58、29.68、239.89、18.59、15.66,P균＜0.05).연구인군총체AKI발생솔위25.9％ (62/239),비고납조AKI발생솔20.5％(39/177),고납조AKI발생솔46.9％(23/62),고납조인군AKI발생솔명현고우비고납조,차이유통계학의의(x2=14.145,P＜0.05);Pearson선성상관분석현시년령、두부수술솔、혈납최고치、감로순총량여AKI정정상관(r치분별위0.458、0.273、0.260、0.490,P균＜0.05).결론 신경중증환자중,고납혈증여AKI적발생정정상관,고납혈증시AKI발생적위험인소.
Objective To explore the correlations between hypernatremia and acute kidney injury in neurocrtically ill patients.Methods Total of 239 neurocrtically ill patients in intensive care unitt of the People' s Hospital of Luanxian of Tangshan from August 2011 to August 2013 were involved in our study.Met the inclusion criteria according to exclusion criteria to select 239 hospitalized patients were included in the analysis.Hypernatremia was diagnosed when the serum sodium level was＞ 145 mmol/L,serum sodium ≤ 145 mmol/L for the first group,serum sodium＞ 145 mmol/L for the second group.Pearson correlation model were used to analyse the correlation between hypernatremia and acute kidney injury.Results The proportion of head surgery,serum sodium when admitted,the highest serum sodium,the total of mannitol and the length of the time staying in hospital of the second group were higher than the first group,and reach statistical significance(63.3％ (31/62) vs.31.1％ (59/177),(143.14±4.90) mmol/L vs.(140.16±2.90) mmol/L,(148.87± 5.30) mmol/L vs.(141.81±2.90) mmol/L,(55.67±28.50) ×250 ml vs.(37.67±25.40) ×250 ml,(57.48±43.30) d vs.(12.33±4.36) d;x2 or F=17.582,29.68,239.89,18.59,5.66;P＜0.05).The overall incidence of AKI of the study population was 25.9％ (62/239).The incidence of AKI of the first group was 20.5 ％ (39/177).The incidence of AKI of the second group was 46.9％ (23/62).The incidence of AKI of the second group was obviously higher than that of the first group,and the difference was statistically significant (x2 =14.145,P ＜0.05).Pearson correlation model showed that age,the proportion of head surgery,the highest blood sodium and the total of mannitol were positively correlated with AKIe (r =0.458,0.273,0.260,0.490,P ＜0.05).Conclusion Hypernatremia is a risk factor for the development of AKI in neurocrtically ill patients.