本文選題：慢性腎臟病 + 急性腎損傷��； 參考：《蘭州大學》2017年碩士論文

【摘要】：目的:回顧性分析研究慢性基礎(chǔ)腎臟疾病患者發(fā)生慢性腎臟疾病合并急性腎損傷的高風險因素。探討慢性腎臟疾病合并急性腎損傷事件患者的預后情況,慢性腎臟疾病合并急性腎損傷事件是否為患者預后的獨立影響因素。方法:回顧性的分析2011年1月至2012年2月期間在蘭州大學第二附屬醫(yī)院住院治療的慢性基礎(chǔ)腎臟疾病患者346例,本研究中慢性腎臟病合并急性腎損傷60例,單純慢性腎臟病的患者286例,出院后對所有患者進行隨訪,記錄患者的腎臟功能情況,對患者的預后情況做系統(tǒng)的評估,SPSS 21.0軟件用于統(tǒng)計學方面的分析,卡方檢驗(X2)用于計數(shù)數(shù)據(jù)分析,兩獨立樣本t檢驗用于兩組間的計量數(shù)據(jù)的統(tǒng)計分析,對慢性腎臟病合并急性腎損傷事件的危險因素分析采取多因素Logistic回歸分析,乘積極限法用于生存方面的分析,Log-rank檢驗用于生存率方面的分析。結(jié)果:1.慢性腎臟疾病合并急性腎損傷共60例,占同期入院患者的5.0%,基礎(chǔ)腎臟疾病病史腎病綜合征、高血壓腎病、糖尿病腎病較易發(fā)生慢性腎臟病合并急性腎損傷事件。2.本研究平均隨訪時間為33.7±17.8月,有效隨訪病人,單純慢性腎臟疾病組254例,慢性腎臟疾病合并急性腎損傷組59例,截止至隨訪時間,單純慢性腎臟病組的死亡率為2.8%,慢性腎臟疾病合并急性腎損傷組的死亡率為20.3%,兩組分析比較差異具有統(tǒng)計學意義(X2=27.7,P=0.001)。3.多元Logistic回歸分析顯示:收縮壓≥140mmHg、舒張壓≥90mmHg、合并糖尿病病史、合并高血壓病史、病程中使用質(zhì)子泵抑制劑是慢性腎臟病合并急性腎損傷的獨立危險因素(OR值分別為1.1,0.8,2.5,1.4,2.8,P值均0.050)。結(jié)論:1.原發(fā)病腎病綜合征、高血壓腎病、糖尿病腎病較易發(fā)生慢性腎臟病合并急性腎損傷。2.收縮壓≥140mmHg、舒張壓≥90mmHg、合并糖尿病病史、合并高血壓病史、病程中使用質(zhì)子泵抑制劑是慢性腎臟病合并急性腎損傷的獨立危險因素。3.與CKD患者相比,ACKD患者人死亡率增加,但腎臟預后與CKD患者無統(tǒng)計學差異。
[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 鹵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，

本文編號：1964820