慢性肾脏疾病合并急性肾损伤的危险因素及预后分析

发布时间：2018-06-01 16:24

  本文选题：慢性肾脏病 + 急性肾损伤　； 参考：《兰州大学》2017年硕士论文

【摘要】：目的:回顾性分析研究慢性基础肾脏疾病患者发生慢性肾脏疾病合并急性肾损伤的高风险因素。探讨慢性肾脏疾病合并急性肾损伤事件患者的预后情况,慢性肾脏疾病合并急性肾损伤事件是否为患者预后的独立影响因素。方法:回顾性的分析2011年1月至2012年2月期间在兰州大学第二附属医院住院治疗的慢性基础肾脏疾病患者346例,本研究中慢性肾脏病合并急性肾损伤60例,单纯慢性肾脏病的患者286例,出院后对所有患者进行随访,记录患者的肾脏功能情况,对患者的预后情况做系统的评估,SPSS 21.0软件用于统计学方面的分析,卡方检验(X2)用于计数数据分析,两独立样本t检验用于两组间的计量数据的统计分析,对慢性肾脏病合并急性肾损伤事件的危险因素分析采取多因素Logistic回归分析,乘积极限法用于生存方面的分析,Log-rank检验用于生存率方面的分析。结果:1.慢性肾脏疾病合并急性肾损伤共60例,占同期入院患者的5.0%,基础肾脏疾病病史肾病综合征、高血压肾病、糖尿病肾病较易发生慢性肾脏病合并急性肾损伤事件。2.本研究平均随访时间为33.7±17.8月,有效随访病人,单纯慢性肾脏疾病组254例,慢性肾脏疾病合并急性肾损伤组59例,截止至随访时间,单纯慢性肾脏病组的死亡率为2.8%,慢性肾脏疾病合并急性肾损伤组的死亡率为20.3%,两组分析比较差异具有统计学意义(X2=27.7,P=0.001)。3.多元Logistic回归分析显示:收缩压≥140mmHg、舒张压≥90mmHg、合并糖尿病病史、合并高血压病史、病程中使用质子泵抑制剂是慢性肾脏病合并急性肾损伤的独立危险因素(OR值分别为1.1,0.8,2.5,1.4,2.8,P值均0.050)。结论:1.原发病肾病综合征、高血压肾病、糖尿病肾病较易发生慢性肾脏病合并急性肾损伤。2.收缩压≥140mmHg、舒张压≥90mmHg、合并糖尿病病史、合并高血压病史、病程中使用质子泵抑制剂是慢性肾脏病合并急性肾损伤的独立危险因素。3.与CKD患者相比,ACKD患者人死亡率增加,但肾脏预后与CKD患者无统计学差异。
[Abstract]:Objective: to study the high risk factors of chronic renal disease complicated with acute renal injury in patients with chronic basic renal disease. To investigate the prognosis of patients with chronic renal disease complicated with acute renal injury and whether the events of chronic renal disease complicated with acute renal injury are independent factors influencing the prognosis of the patients. Methods: from January 2011 to February 2012, 346 patients with chronic basic renal disease were hospitalized in the second affiliated Hospital of Lanzhou University. 60 patients with chronic kidney disease complicated with acute renal injury were studied in this study. 286 patients with simple chronic kidney disease were followed up after discharge to record the renal function and the prognosis of the patients. SPSS21.0 software was used for statistical analysis. Chi square test X 2) was used for counting data analysis, two independent samples t test was used for statistical analysis of measurement data between two groups, and multivariate Logistic regression analysis was used to analyze the risk factors of chronic kidney disease complicated with acute renal injury. The product limit method for survival analysis and Log-rank test for survival analysis. The result is 1: 1. There were 60 cases of chronic renal disease complicated with acute renal injury, which accounted for 5.0% of the hospitalized patients in the same period. The history of basic kidney disease was nephrotic syndrome, hypertension nephropathy and diabetic nephropathy were more likely to develop chronic kidney disease complicated with acute renal injury events. The average follow-up time of this study was 33.7 卤17.8 months. There were 254 patients with simple chronic renal disease and 59 patients with chronic renal disease complicated with acute renal injury. The mortality rate of chronic kidney disease group was 2.8 and that of chronic kidney disease complicated with acute renal injury group was 20.3.The difference between the two groups was statistically significant. Multivariate Logistic regression analysis showed that systolic blood pressure 鈮，

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