CAJ | 학술논문

目的：比较不同感染部位急性肾损伤（AKI）患者的临床特征及预后的影响因素。方法以KDIGO推荐的AKI诊断标准，收集2012年1月至2014年12月入住苏北人民医院ICU患者临床资料，根据感染部位不同分为肺部感染组（216例）及腹腔感染组（132例），比较两组临床特征及采用 Logistic 回归分析筛选不同感染部位预后相关的危险因素。结果腹腔感染合并 AKI患者与肺部感染合并AKI患者相比更多为外科来源及合并有肿瘤，腹腔感染患者血管活性药物使用的人数较多（P＜0.05），白蛋白水平及白细胞总数、平均动脉压较肺部感染患者低（P＜0.05）。经多因素回归分析，白蛋白及APACHEⅡ评分为影响腹腔感染合并AKI患者的独立预后因素。氧合指数及APACHEⅡ评分为影响肺部感染合并AKI患者的独立预后因素。结论不同部位感染合并AKI患者有不同的临床特征。氧合指数是影响肺部感染患者预后的指标，低蛋白血症是影响腹腔感染患者预后的指标，APACHEⅡ评分对两组患者预后均有影响。不同部位感染患者死亡率均高。
목적：비교불동감염부위급성신손상（AKI）환자적림상특정급예후적영향인소。방법이KDIGO추천적AKI진단표준，수집2012년1월지2014년12월입주소북인민의원ICU환자림상자료，근거감염부위불동분위폐부감염조（216례）급복강감염조（132례），비교량조림상특정급채용 Logistic 회귀분석사선불동감염부위예후상관적위험인소。결과복강감염합병 AKI환자여폐부감염합병AKI환자상비경다위외과래원급합병유종류，복강감염환자혈관활성약물사용적인수교다（P＜0.05），백단백수평급백세포총수、평균동맥압교폐부감염환자저（P＜0.05）。경다인소회귀분석，백단백급APACHEⅡ평분위영향복강감염합병AKI환자적독립예후인소。양합지수급APACHEⅡ평분위영향폐부감염합병AKI환자적독립예후인소。결론불동부위감염합병AKI환자유불동적림상특정。양합지수시영향폐부감염환자예후적지표，저단백혈증시영향복강감염환자예후적지표，APACHEⅡ평분대량조환자예후균유영향。불동부위감염환자사망솔균고。
ObjectiveTo compare clinical characteristics of AKI patients with sepsis originating from different infection sites and investigate the risk factors related to prognosis of these patients.Methods We performed a retrospective study of ICU patients over two years period at Subei People's Hospital. AKI was evaluated according to the KDIGO criteria. Based on infection source, these patients were classified into two groups: intra-abdominal and pulmonary infections. The clinical characteristics were compared between the two groups. The potential risk factors were analyzed by Logistic regression analysis.Results Intra-abdominal infections more frequently had surgery, cancer and vasoactive agents (P<0.05). Intra-abdominal infections had less albumin, white blood cell count and mean arterial pressure. The Logistic regression suggested that albumin and APACHEⅡ were the independent risk factors of intra-abdominal infections, oxygenation index and APACHEⅡ were the independent risk factors of pulmonary infections.Conclusions The investigation confirms that different infection sites have different clinical characteristics. Oxygenation index may be used for the prognosis of the patients with pulmonary infections, albumin may be used for the prognosis of the patients with intra-abdominal infections, APACHEⅡ score of two groups all affect the prognosis of patients. The mortality of patients with different sites was high.