多器官功能障碍综合征合并急性肾损伤的相关危险因素分析

多器官功能障碍综合征合并急性肾损伤的相关危险因素分析王函;李清初;陆明;李小红;尹友生
【期刊名称】《海南医学》
【年(卷),期】2016(0)10
【摘要】Objective To investigate the risk factors for multiple organ dysfunction syndrome (MODS) compli-cated with acute renal injury (AKI), and to provide evidence for the treatment of MODS. Methods The clinical data of 241 patients with MODS in our hospital from January 2011 to June 2015 were retrospectively reviewed, including 149 patients with AKI (study group) and 92 patients without AKI (control group). The related risk factors of AKI combined with MODS were analyzed by single factor and multi-factor logistic regression analysis. Results Among 241 patients of MODS, 149 were found to be combined with AKI (accounting for 61.83%). Single factor analysis showed that age, re-spiratory rate, blood glucose, blood sodium, cardiac output and blood creatinine were significantly higher in the study group than those in the control group (P<0.05). The blood pressure, central venous pressure, pH, and peripheral blood vessel resistance were significantly lower than those in the control group (P<0.05). The application rates of enteral nutri-tion, blood purification and mechanical ventilation were significantly lower than those of the control group (P<0.05). Multi-factor logistic regression analysis showed that age, systolic blood pressure, central venous pressure, blood creatinine peak,
oxygenation index were the main risk factors for death of MODS patients with AKI, and enteral nutrition, blood puri-fication and mechanical ventilation were the protective factors of death in patients with MODS combined with AKI (P<0.05). Conclusion Age, systolic pressure, central venous pressure, blood creatinine peak, oxygen index, arterial blood pressure are the main risk factors of MODS combined with AKI, and enteral nutrition, blood purification and mechanical ventilation can effectively reduce the incidence of AKI, which should be paid attention to in clinical treatment.%目的：探讨多器官功能障碍综合征(MODS)合并急性肾损伤(AKI)的相关危险因素，为MODS治疗提供依据。

方法对我院2011年1月至2015年6月间收治的241例MODS患者进行回顾性分析，其中合并AKI患者149例作为观察组，未合并AKI患者92例作为对照组，应用单因素和多因素Logistic回归分析分析MODS合并AKI的相关危险因素。

结果241例MODS患者中合并AKI 149例，占61.83%。

单因素分析显示，观察组患者的年龄、呼吸频率、血糖、血钠、心输出量、血肌酐峰值显著高于对照组，血压、中心静脉压、pH值、外周血管阻力显著低于对照组，肠内营养、血液净化、机械通气应用率显著低于对照组，差异均有统计学意义(P<0.05)。

多因素Logistic回归分析显示，年龄、收缩压、中心静脉压、血肌酐峰值、氧合指数是MODS合并AKI患者死亡的主要危险因素，而肠内营养、血液净化和机械通气是MODS合并AKI患者死亡的保护性因素
(P<0.05)。

结论年龄、收缩压、中心静脉压、血肌酐峰值、氧合指数、动脉血二氧化碳分压是MODS合并AKI的主要危险因素，而肠内营养、血液净化和机械通气可以有效降低AKI发生率，临床治疗应予以重视。

【总页数】3页(P1608-1610)
【作者】王函;李清初;陆明;李小红;尹友生
【作者单位】桂林医学院附属医院肾内科，广西桂林 541001;桂林医学院附属医院肾内科，广西桂林 541001;桂林市中西医结合医院外二科，广西桂林 541004;桂林医学院附属医院肾内科，广西桂林 541001;桂林医学院附属医院肾内科，广西桂林 541001
【正文语种】中文
【中图分类】R442.8
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