摘要
目的探讨发生急性肾损伤(AKI)的老年住院患者90 d预后的影响因素及中医证型与患者预后的相关性。方法回顾性分析2014年1月—2023年10月于我院住院,符合急性肾损伤诊断标准,且年龄≥60岁患者的临床资料,分析患者发生AKI后90 d临床预后的影响因素及中医证型对其预后的影响。结果共纳入156例老年AKI患者,其中预后良好组127例,预后不良组29例。单因素分析结果显示:两组患者在合并恶性肿瘤、AKI分期、低蛋白血症、感染、脓毒血症、C反应蛋白(CRP)、应用血管活性药物、应用利尿剂方面比较,组间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:合并恶性肿瘤、AKI分期、低蛋白血症、感染、脓毒血症、CRP为老年AKI患者90 d预后不良的独立危险因素(P<0.05)。两组热毒炽盛证占比比较,差异有统计学意义(P<0.05)。结论合并恶性肿瘤、AKI分期、低蛋白血症、感染、脓毒血症、CRP是老年AKI患者90 d预后的主要危险因素,患者辨证为热毒炽盛证临床预后差,临床治疗中应对此加以关注,以改善患者预后。
Objective To investigate the factors influencing the 90-day prognosis of Acute Kidney Injury(AKI)in elderly hospitalized patients and the correlation between TCM syndrome types and prognosis.Methods The clinical data of patients≥60 years old who met the diagnostic criteria of acute kidney injury and were hospitalized in our hospital from January 2014 to October 2023 were retrospectively analyzed.The influencing factors of clinical prognosis 90 days after AKI and the effect of traditional Chinese medicine syndrome types on their prognosis were analyzed.Results A total of 156 eligible elderly AKI patients were included,including 127 cases in the good prognosis group and 29 cases in the poor prognosis group.Univariate analysis showed that there were statistically significant differences between the good prognosis group and the poor prognosis group in terms of the combination of malignant tumour,AKI stage,hypoproteinemia,infection,sepsis,C-reactive protein(CRP),application of vasoactive drugs,and the application of diuretics(P<0.05).Multifactorial Logistic regression analysis showed that combination of malignancy,AKI stage,hypoproteinemia,infection,sepsis,and CRP were independent risk factors for poor 90-day prognosis in elderly patients with AKI(P<0.05).There was a statistically significant difference in the proportion of heat toxin excess syndrome between the two groups(P<0.05).Conclusion Malignant tumor,AKI stage,hypoproteinemia,infection,sepsis and CRP are the main risk factors for the 90-day prognosis of elderly patients with AKI.Patients with syndrome differentiation of heat and toxin excess have poor clinical prognosis,which should be paid attention to in clinical treatment to improve the prognosis of patients.
作者
余杭英
陈专心
朱彩凤
YU Hangyin;CHEN Zhuanxin;ZHU Caifeng(Department of Nephrology,Chun'an Campus of Hangzhou Traditional Chinese Medicine Hospital,Hangzhou Zhejiang,311700,China;Department of Nephrology,Hangzhoutraditional Chinese Medicine Hospital,Hangzhou Zhejiang,310007,China)
出处
《反射疗法与康复医学》
2024年第7期171-176,共6页
Reflexology And Rehabilitation Medicine
基金
浙江省中医药科技计划项目(No.2019ZQ040)
关键词
急性肾损伤
老年住院患者
90
d预后
影响因素
中医证型
Acute kidney injury
Elderly inpatients
90-Day prognosis
Influence factor
TCM syndrome types
