实用医学杂志 ›› 2021, Vol. 37 ›› Issue (4): 477-481.doi: 10.3969/j.issn.1006⁃5725.2021.04.012

• 临床研究 • 上一篇    下一篇

腹腔感染引起的脓毒性休克患者发生急性肾损伤的危险因素分析

陈丽娟,吴晓丽,秦海艳,朱蕻潮,李进冬   

  1. 南京医科大学附属淮安第一医院1 临床药学室,2 核医学科(江苏淮安 223300); 3 泰州市人民医院(江苏泰州225300)

  • 出版日期:2021-02-25 发布日期:2021-02-25
  • 通讯作者: 朱蕻潮 E⁃mail:zhuhongchao366@126.com
  • 基金资助:
    江苏省药学会⁃天晴医院药学基金(编号:Q2019105)

Analysis of risk factors for acute kidney injury in patients with septic shock caused by intra ⁃abdominal infection

CHEN Lijuan,WU Xiaoli,QIN Haiyan,ZHU Hongchao,LI Jindong   

  1. Department of Pharmacy,the Affiliated Huaian NO.1 People′s Hospital of NanJing Medical University,Huaian 223300,China

  • Online:2021-02-25 Published:2021-02-25
  • Contact: ZHU Hongchao E⁃mail:zhuhongchao366@126.com

摘要:

目的 研究 ICU 入院时因腹腔感染引起的脓毒性休克患者发生急性肾损伤的危险 因素。方法 回顾性分析 129 例腹腔感染引起的脓毒性休克患者的临床资料,根据是否发生脓毒性 休克相关急性肾损伤(AKI)分为 AKI 56 例,非 AKI 73 例。采用单因素分析法比较两组临床资料, Logistic 回归分析腹腔感染引起的脓毒性休克患者发生急性肾损伤的危险因素,应用 ROC 曲线评价活化部分凝血活酶时间(APTT)、降钙素原(PCT)在诊断 AKI 方面的能力。结果 AKI PCT、APTT 血清白蛋白(Alb)等指标与非 AKI 组比较差异均有统计学意义(P < 0.05);APTT,PCT 是患者发展为 AKI 的独立危险因素(P < 0.01),Alb AKI 的保护因素(P < 0.05);APTT PCT 曲线下面积(AUC > 0.8,APTT 75.0% 、85.2% ,PCT 73.4% 、74.1% 结论 腹腔感染引起的脓毒性休克患者,入 ICU 时的 APTT、PCT 水平是 AKI 风险增加的独立危险因 素,Alb AKI 风险增加的保护因素;APTT PCT 在评估脓毒性休克患者发生 AKI 方面具有一定的诊断效能。

关键词:

活化部分凝血酶原时间, 降钙素原, 血清白蛋白, 脓毒性休克, 急性肾损伤, 腔感染

Abstract:

Objective To investigate the risk factors of acute kidney injury in patients with septic shock caused by intra⁃abdominal infection. Methods 129 patients were enrolled and then 56 cases were divided into in AKI group and 73 cases in non⁃AKI group. The clinical data of the two groups were compared by univariate analy⁃ sis. Multiple logistic regression analysis was used to analyze the risk factors of Septic acute kidney injury in ICU patients. Using ROC curve to evaluate the ability of APTT and PCT in diagnosing AKI. Results Compared with the non⁃AKI group,PCT,APTT,serum albumin(Alb)et.al were statistically significant in AKI group(all P < 0.05). APTT,PCT were independent risk factors for S⁃AKI(P < 0.01),and Alb was known as an independent protective factor for Septic acute kidney injury(P < 0.05);The area under the curve(AUC)of APTT and PCT was greater than 0.8,the sensitivity and specificity of APTT and PCT were 75.0% ,85.2% ,73.4% ,74.1% respectively. Conclusion APTT and PCT level on admission to the ICU are significantly associated with acute kidney injury in patients with septic shock caused by intra⁃abdominal infection,and Alb level is known as an independent protec⁃ tive factor;APTT and PCT have certain diagnostic efficacy in evaluating Septic acute kidney injury.

Key words:

activated partial thromboplastin time, procalcitonin, septic shock, serum albumin, acute kidney injury, intra?abdominal infection