脓毒性休克并发急性肾损伤的危险因素研究

    Study on the risk factors of septic shock complicated with acute Kidney injury

    • 摘要:
      目的调查脓毒性休克病人急性肾损伤(AKI)的影响因素。
      方法选择脓毒性休克病人144例,按照AKI发生情况分为AKI组84例和非AKI组60例,比较2组病人一般资料及临床相关指标,进行单因素分析,并对差异有统计学意义的项目进行logistic回归分析,分析AKI的影响因素。
      结果AKI组与非AKI组合并糖尿病、平均动脉压、肾小球滤过率和乳酸、尿素氮、D-二聚体水平及机械通气、血液净化治疗、呋塞米单日最大剂量差异均有统计学意义(P < 0.05~P < 0.01);2组年龄、性别、体质量指数差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,合并糖尿病、平均动脉压、血清乳酸水平、机械通气、呋塞米单日最大剂量均为脓毒性休克病人发生AKI的独立影响因素(P < 0.05~P < 0.01)。
      结论脓毒性休克病人AKI发生率较高,合并糖尿病和低平均动脉压、高血清乳酸水平及机械通气、高呋塞米单日最大剂量均为其独立危险因素,临床应针对高危病人及早采取干预措施。

       

      Abstract:
      ObjectiveTo investigate the influencing factors of acute kidney injury(AKI) in patients with septic shock.
      MethodsA total of 144 patients with septic shock were divided into the AKI group and non-AKI group according to the incidence of AKI.The general data and clinical indicators between two groups were compared, and analyzed using the univariate analysis method.The items with significant difference were analyzed using the logistic regression analysis method to explore the influencing factors of AKI.
      ResultsThe differences of the combined diabetes, mean arterial pressure, glomerular filtration rate, levels of serum lactate, urea nitrogen and D-dimer, mechanical ventilation, blood purification therapy, maximum daily dose of furosemide were statistically significant(P < 0.05 to P < 0.01).The differences of the age, gender and body mass index between two groups were not statistically significant(P>0.05).The results of logistic regression analysis showed that the combined diabetes, mean arterial pressure, serum lactate level, mechanical ventilation and maximum daily dose of furosemide were the independent factors influencing AKI in patients with septic shock(P < 0.05 to P < 0.01).
      ConclusionsThe incidence rate of AKI is higher in patients with septic shock.The combined diabetes, mean arterial pressure, serum lactate level, mechanical ventilation, maximum daily dose of furosemide are the independent factors influencing AKI in patients with septic shock, and the clinical intervention measures should be taken early for high-risk patients.

       

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