摘要
目的了解多发软组织损伤患者中急性肾损伤（AKI）的发生情况，筛选与AKI发生相关的临床危险因素。方法选择2008年1月1Et至2013年1月1日新疆医科大学第一附属医院513例诊断为多发软组织损伤且资料完整的住院患者。收集患者的人口统计学资料、AKI发生前后的临床资料和实验室检查结果，回顾性分析多发软组织损伤后AK!发生相关的独立危险因素。结果513例患者的年龄为31（12～78）岁，男女比例为2．1：1。其中74例发生AKI，发生率为14．4％。殴打伤患者中无AKI发生，车祸伤患者中发生27例（36．5％），其他原因损伤4例（5．4％）。损伤面积〈1％的患者中发生AKI为1例（1．4％），损伤面积1％～〈3％的患者中发生AKI为4例（5．4％），损伤面积3％～5％的患者中发生AKI为10例（13．5％），损伤面积〉5％的患者中发生AKI为19例（25．7％），各组差异有统计学意义（P〈0．01）。伴有慢性肾脏病患者AKI的发生率显著高于不伴有慢性肾脏病的患者（54．5％比20．3％，P〈0．01）。74例AKI患者中死亡2例，病死率为2．7％。多因素logistic回归分析显示，年龄（OR=1．996）、基础血肌酐（SCr）水平（OR=0．976）、基础估算的。肾小球滤过率（eGFR）（OR=0．964）、血钾（OR=2．117）、肌红蛋白（OR=0．950）、损伤面积（OR：1．811）是多发软组织损伤患者发生AKI的独立危险因素。结论多发软组织损伤患者中AKI的发病率较高。年龄、基础SCr、基础eGFR、血钾、肌红蛋白、损伤面积是多发软组织损伤患者发生AKI的独立危险因素。
Objective To investigate the incidence and risk factors of acute kidney injury （AKI） in patients with multiple soft tissue contusion. Methods A total of 513 patients diagnosed as multiple soft tissue contusion in the First Affiliated Hospital of Xinjiang Medical University from January 1,2008 to January 1,2013 were retrospectively analyzed. Demographics, clinical data and laboratory examinations before and after AKI were collected and analyzed. Results The age of all subjects was 31.30 （ 12 - 78 ） years old with the male to female ratio of 2. 1： 1. AKI occurred in 74 cases with an incidence rate of 14.4%. No AKI was observed in patients with assault injuries, while AKI was found in 27 cases （36. 5% ） with car accident injuries and 4 cases （5.4%） with other injuries. AKI showed in 1 case（ 1.4% ） with damaged area under 1%, in 4 cases （5.4%） with damaged area ranged from 1% to 〈 3%, 10 cases （ 13.5% ） with damaged area ranged from 3% to 5% and 19 cases （25.7%） with damaged area over 5% with significant difference among the groups （ P 〈 O. 01 ）. Incidence rate of AKI was significantly higher in patients with chronic kidney disease （CKD） than those without CKD （54. 5% vs 20. 3%, P 〈 0. 01 ）. Two of the AKI cases died, with a mortality rate of 2.7%. Multivariate logistic regression analysis showed that the followings were the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injuries ： age （ OR = 1. 996）, basic serum creatinine （ OR = 0. 976）, basic evaluated GFR （eGFR） （ OR = O. 964 ）, serum potassium （ OR =2. 117）, myoglobin （ OR =0. 950） and damaged area （ OR = 1. 811 ）. Conclusions Incidence rate of AKI is quite high in multiple soft tissue contusion. Age, basic serum creatinine, basic eGFR, serum potassium, myoglobin and damaged area are the independent risk factors for the occurrence ofAKI in patients with multiple soft tissue injury.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2014年第3期174-177,共4页
Chinese Journal of Internal Medicine
关键词
软组织损伤
肾功能不全
急性
发生率
危险因素
Soft tissue injuries
Renal insufficiency, acute
Incidence
Risk factor
