摘要
目的探讨AKIN分期在创伤后急性肾损伤(AKI)患者进行连续性肾脏替代治疗(CRRT)时机选择中的应用价值。方法创伤后AKI患者84例按AKIN标准分为1期(32例)、2期(22例)和3期(30例)。均采用CRRT治疗,检测治疗前和治疗24h后APACHEⅡ评分、氧合指数、血清肌酐、血尿素氮、血钾和血乳酸值,比较三组患者的病死率。结果 AKIN 3期组患者病死率为80.0%(24/30),AKIN 2期组病死率为68.2%(15/22),均明显高于AKIN 1期组的37.5%(12/32)(P<0.05)。CRRT治疗24h后,三组患者APACHEⅡ评分、血清肌酐、血尿素氮和血钾均明显下降(P<0.05);治疗24h后,AKIN 1期患者的氧合指数显著升高、血乳酸值显著降低(P<0.05),但在AKIN 2、3期患者则无明显变化。结论 AKIN标准对创伤后AKI患者的早期诊断和预后判断有重要指导意义。
Objective To investigate the value of acute kidney injury network（AKIN） staging for post-traumatic acute kidney injury（AKI） in selecting the time of continuous renal replacement therapy（CRRT） in AKI patients. Methods A total of 84 adult patients with post-traumatic AKI was classified as AKIN phase 1 （32 cases）, AKIN phase 2 （22 cases） and AKIN phase 3 （ 30 cases）. The mortality rate was compared among three groups. The APACHE Ⅱ score, serum creatinine, blood urean nitrogen, plasma potassium and blood lactate were evaluated before and at 24 hours after CRRT. Results The mortality rates in the patients with AKIN phase 3 and 2 were 80. 0% and 68. 2 %, respectively, which were higher than 37.5% in the cases with AKIN phase 1（P（0. 05）. After CRRT for 24 hours, APACHE lI score, serum creatinine, blood urean nitrogen and plasma potassium were improved significantly in all patients （P〈0. 05）. Oxygnation index and blood lactate were improved significantly in patients with AKIN phase 1（P〈0. 05）, but not in those with AKIN phase 2 or 3. Conclusion AKIN criteria for staging AKI is useful for the early diagnosis and prognosis prediction in the patients with oost-traumatic AKI.
出处
《江苏医药》
CAS
CSCD
北大核心
2012年第21期2578-2580,共3页
Jiangsu Medical Journal
关键词
急性肾损伤
连续性肾脏替代治疗
AKIN标准
Acute kidney injury
Continuous renal replacement therapy
Acute kidney injurynetwork criteria
