本文選題：急性腎功能不全 + 預(yù)后�。� 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:回顧性分析新疆地區(qū)社區(qū)獲得性急性腎損傷(CA-AKI)與醫(yī)院獲得性急性腎損傷(HA-AKI)患者的人口學(xué)特征、疾病危險(xiǎn)因素及死亡相關(guān)危險(xiǎn)因素等。方法:應(yīng)用醫(yī)院病例系統(tǒng)篩選新疆醫(yī)科大學(xué)第一附屬醫(yī)院2014年1月、7月19 528例成人住院患者臨床資料。根據(jù)改善全球腎臟病預(yù)后組織(KDIGO)指南確認(rèn)544例AKI患者組成研究隊(duì)列,按照發(fā)病時(shí)間與入院時(shí)間的關(guān)系,將上述患者分成CA-AKI組與HA-AKI組。回顧性分析CA-AKI組(330例)與HA-AKI組(214例)患者的臨床資料及全因死亡率。結(jié)果:住院患者AKI發(fā)生率為2.8%(544/19 528),其中CA-AKI組為1.7%(330/19 528),HA-AKI組為1.1%(214/19 528)。CA-AKI組患者平均年齡大于HA-AKI組[(62.9±16.8)歲比(56.6±15.9)歲,P0.01]。CA-AKI組中62.4%為內(nèi)科患者,HA-AKI組中64.1%為外科患者。兩組合并的基礎(chǔ)疾病主要包括心血管系統(tǒng)疾病、高血壓、糖尿病和慢性肝病。腎前性因素在兩組均占明顯優(yōu)勢。CA-AKI組住院時(shí)間明顯少于HA-AKI組[12(8,20)d比19(12,27)d,P0.01],全因死亡率亦明顯低于HA-AKI組(11.5%比20.1%,P=0.005)。多因素Logistic逐步回歸結(jié)果提示,ICU住院情況和休克是CA-AKI組和HA-AKI組患者死亡的獨(dú)立危險(xiǎn)因素;糖尿病(OR=3.019)是CA-AKI組患者死亡的獨(dú)立危險(xiǎn)因素;高齡(OR=3.303)、少尿(OR=6.906)、使用解熱鎮(zhèn)痛藥(OR=13.079)及存在多器官功能不全綜合征(OR=17.778)是HA-AKI組患者死亡的獨(dú)立危險(xiǎn)因素。結(jié)論:住院患者中AKI的發(fā)生并不少見,腎前性病因均為CA-AKI與HA-AKI主要病因。HA-AKI組全因死亡率明顯高于CA-AKI組,兩組預(yù)后的獨(dú)立危險(xiǎn)因素不盡相同。
[Abstract]:Objective: to retrospectively analyze the demographic characteristics, disease risk factors and death risk factors of patients with acute renal injury (CA-AKI) and hospital acquired acute renal injury (HA-AKI) in Xinjiang. Methods: the clinical data of 19 528 adult inpatients in the first affiliated Hospital of Xinjiang Medical University in January and July 2014 were screened by the hospital case system. According to the KDIGO guidelines for improving the prognosis of Nephropathy, 544 patients with AKI were cohort. According to the relationship between onset time and admission time, the patients were divided into CA-AKI group and HA-AKI group. The clinical data and total cause mortality of CA-AKI group (330 cases) and HA-AKI group (214 cases) were analyzed retrospectively. Results: the incidence of AKI in hospitalized patients was 2.84% 19 528%. The average age of HA-AKI patients in CA-AKI group was 1.30 / 19 528% higher than that in HA-AKI group [62.9 鹵16.8 years old vs 56.6 鹵15.9yr P0.01]. 62.4% of the patients in CA-AKI group were surgical patients in HA-AKI group, 64.1% in HA-AKI group were surgical patients, the average age of HA-AKI group was higher than that of HA-AKI group [62.9 鹵16.8 years old vs 56.6 鹵15.9years old P0.01]. The average age of HA-AKI group in CA-AKI group was 64.1% in HA-AKI group. The underlying diseases in both groups included cardiovascular diseases, hypertension, diabetes, and chronic liver disease. The prerenal factors were significantly superior in both groups. The hospitalization time of CA-AKI group was significantly less than that of HA-AKI group [128U / 20d vs 1912121227dU P0.01], and the total mortality rate was significantly lower than that of HA-AKI group (11.5% vs 20.1g / kg). The results of stepwise regression of multivariate Logistic suggested that hospitalization and shock were independent risk factors for death in CA-AKI group and HA-AKI group, and diabetes mellitus 3.019) was an independent risk factor for death in CA-AKI group. The risk factors of death in the HA-AKI group were 3.303g, 6.906g, 13.079) and 17.778), which were used as antipyretic analgesics, and with multiple organ dysfunction syndrome (MOS), which were the independent risk factors of death in HA-AKI group. Conclusion: the incidence of AKI is not uncommon in inpatients. The main causes of prerenal venereal diseases are CA-AKI and HA-AKI. The all-cause mortality in HA-AKI group is significantly higher than that in CA-AKI group, and the independent risk factors for prognosis are different between the two groups.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郝志玲;;不同分期糖尿病腎病患者蛋白尿甲狀腺激素C-反應(yīng)蛋白的相關(guān)性分析[J];中國藥物與臨床;2013年01期

2 黃宏超;;C反應(yīng)蛋白監(jiān)測在血糖控制中的價(jià)值[J];當(dāng)代醫(yī)學(xué);2012年16期

3 馬靜;劉辰庚;;2型糖尿病血漿纖維蛋白原、血小板參數(shù)及高敏CRP與微血管病變的關(guān)系[J];四川醫(yī)學(xué);2012年03期

4 吳文輝;;超敏C-反應(yīng)蛋白測定在2型糖尿病腎損傷診斷中的應(yīng)用[J];中外醫(yī)療;2010年35期

5 周秀艷;侯振江;邢桂芝;;血清C-反應(yīng)蛋白與2型糖尿病腎病的關(guān)系[J];中國老年學(xué)雜志;2007年08期

6 謝新榮;蔣紅焱;;羅格列酮對早期糖尿病腎病患者尿微量白蛋白及C-反應(yīng)蛋白水平的影響[J];中國醫(yī)師進(jìn)修雜志;2006年31期

7 裴寧;李益明;;65例1型糖尿病腎病患者血C反應(yīng)蛋白和白介素6的改變[J];實(shí)用全科醫(yī)學(xué);2006年03期

8 李明;梁瑋;劉暢;;C反應(yīng)蛋白與糖尿病血管并發(fā)癥的關(guān)系[J];臨床薈萃;2006年01期

9 曹禮應(yīng);余月明;郭虹;段建;王柏青;;糖尿病終末期腎病血液透析患者C-反應(yīng)蛋白水平[J];昆明醫(yī)學(xué)院學(xué)報(bào);2005年04期

10 李新勝,張金城,錢洪霞;胰島素治療對2型糖尿病腎病血清C反應(yīng)蛋白水平的影響[J];中國中西醫(yī)結(jié)合腎病雜志;2005年09期

，

本文編號：1972067