烧伤合并急性肾损伤患者向慢性肾脏病转归的相关因素

发布时间：2018-04-14 23:34

本文选题：烧伤 + 慢性肾脏病　；参考：《上海医学》2016年05期

【摘要】：目的探讨烧伤合并急性肾损伤(AKI)向慢性肾脏病(CKD)转归的相关因素。方法收集2010年1月—2014年12月在上海长海医院烧伤科和烧伤科ICU接受治疗的164例烧伤合并AKI的患者,根据治疗后患者病情的转归将患者分为CKD组和肾功能恢复组(RRF组),每组各82例。比较两组患者的一般资料,血常规、肾功能指标,以及少尿、烧伤休克、脓毒血症、AKI分期患者构成比,并分析烧伤合并AKI向CKD转归的相关因素。结果 CKD组白细胞计数显著高于RRF组(P0.05),少尿、烧伤休克、脓毒血症和行肾脏替代治疗的患者构成比均显著高于RRF组(P值分别0.05、0.01)。两组间血红蛋白、血清白蛋白、血清肌酐、血清尿素氮、血钠水平、血钾水平和AKI分期患者构成比的差异均无统计学意义(P值均0.05)。Logistic单因素回归分析显示,住院期间发生脓毒血症(OR=5.3,95%CI为2.7~9.8)、烧伤休克(OR=4.6,95%CI为2.3~6.1)、少尿患者构成比(OR=3.2,95%CI为1.5~4.2)为烧伤合并AKI患者转归为CKD的独立危险因素(P值均0.05)。Logistic多因素回归分析显示,脓毒血症(OR=4.7,95%CI为2.6~8.1)和烧伤休克(OR=3.8,95%CI为2.1~6.7)为烧伤合并AKI患者转归为CKD的重要影响因素(P值均0.05)。结论对于烧伤合并AKI的患者,脓毒血症和烧伤休克是患者转归CKD的主要危险因素。
[Abstract]:Objective to investigate the factors related to the outcome of burn with acute renal injury (AKI) to chronic renal disease (CKD).Methods from January 2010 to December 2014, 164 patients with burn and AKI were treated in the Department of Burn and ICU of Shanghai Changhai Hospital.According to the outcome of the treatment, the patients were divided into CKD group and renal function recovery group, 82 cases in each group.The general data, blood routine examination, renal function index, composition ratio of patients with oliguria, burn shock, sepsis and AKI staging were compared between the two groups, and the factors related to the outcome of AKI to CKD were analyzed.Results the WBC count in CKD group was significantly higher than that in RRF group (P 0.05), oliguria, burn shock, sepsis and renal replacement therapy.There was no significant difference in hemoglobin, serum albumin, serum creatinine, serum urea nitrogen, serum sodium level, serum potassium level and the ratio of AKI staging patients between the two groups. There was no significant difference in P value between the two groups by 0.05).Logistic single factor regression analysis.During hospitalization, the CI of the patients with sepsis or sepsis was 2.70.9.8cm, the CI of burn shock patients was 4.6c95CI was 2.3 卤6.1g, the composition of patients with oliguria was 3.2995 CI = 1.54.2.) the independent risk factors P value of burn patients with AKI were all 0.05).Logistic multivariate regression analysis, and the regression analysis showed that the risk factors for the outcome of burn patients with AKI were all 0.05).Logistic multivariate regression analysis.The CI of the patients with sepsis or sepsis was 2.6 卤8.1and the CI of burn shock was 3.895 CI was 2.10.6.7. the important factors influencing the outcome of burn patients with AKI were 0.05g / L and 0.05g / L, respectively.Conclusion sepsis and burn shock are the main risk factors for CKD in patients with AKI.
【作者单位】：上海长海医院肾内科;
【分类号】：R644;R692

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