蛛网膜下腔出血患者急性肾损伤相关危险因素及预后

发布时间：2018-07-26 06:21

【摘要】：目的对蛛网膜下腔出血(SAH)患者急性肾损伤(AKI)的发病率、危险因素及其预后情况进行临床分析。方法回顾性收集2012年1月至2013年10月首都医科大学附属北京天坛医院神经重症监护室SAH患者的临床资料,对比AKI与非AKI患者临床特征差异,采用多因素Logistic回归模型分析AKI发病独立危险因素。结果 269例SAH患者纳入研究,AKI发病率为14.5%。AKI组平均年龄(60.8±11.9)岁,非AKI组平均年龄(55.4±11.6)岁(P0.05),AKI组入院NIHSS评分及血肌酐水平均高于非AKI组,入院GCS评分低于非AKI组(均P0.05)。AKI组尿蛋白阳性比例、合并感染比例及利尿剂使用率均高于非AKI组(均P0.05)。多因素Logistic回归结果显示,AKI发病的独立危险因素为年龄、入院GCS评分及合并感染[OR值(95%CI)分别为1.037(1.006,1.068),0.873(0.802,0.951),3.624(1.543,8.514);均P0.05]。AKI组患者病死率28.2%,非AKI组为0.8%,两组比较具有统计学差异(P0.01)。结论 NICU住院SAH患者AKI发病率较高,此类患者住院病死率显著增加。高龄、原发病严重程度、合并感染可能是AKI发生的独立危险因素。
[Abstract]:Objective to analyze the incidence, risk factors and prognosis of acute renal injury (AKI) in patients with subarachnoid hemorrhage (SAH). Methods from January 2012 to October 2013, the clinical data of SAH patients in the Neuro-intensive Care Unit of Beijing Temple of Heaven Hospital affiliated to Capital Medical University were collected retrospectively, and the clinical characteristics of AKI and non-AKI patients were compared. Multivariate Logistic regression model was used to analyze the independent risk factors of AKI. Results the average age of 14.5%.AKI group was (60.8 卤11.9) years old, the mean age of non-AKI group was (55.4 卤11.6) years old (P0.05), the mean NIHSS score and serum creatinine level in non-AKI group were higher than those in non-AKI group, and the GCS score in admission was lower than that in non-AKI group (P0.05). The rate of co-infection and the rate of diuretic use were higher than those of non-AKI group (P0.05). The results of multivariate Logistic regression showed that the independent risk factors were age, GCS score of admission and co-infection [OR (95%CI) were 1.037 (1.0061.068) (0.8020.9051) 3.624 (1.5438.514) respectively, P0.05] .AKI group was 28.22and non-AKI group was 0.8.The difference between the two groups was statistically significant (P0.01). Conclusion the incidence of AKI in SAH patients with NICU is higher, and the fatality rate of these patients increases significantly. Old age, severity of primary disease, and co-infection may be independent risk factors for the occurrence of AKI.
【作者单位】：首都医科大学附属北京天坛医院肾内科;首都医科大学附属北京世纪坛医院肾内科;
【基金】：北京市科学技术委员会首都临床特色应用研究基金项目(编号:Z141107002514150) 北京天坛医院青年科研基金项目(编号:2013-YQN-05)
【分类号】：R692.5;R743.35

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