影响急性肾功能衰竭患者住院病死率与肾脏预后的危险因素分析

目的：探讨影响急性肾功能衰竭（ARF）住院患者病死率与肾脏预后的危险因素，以提高ARF的治疗水平。方法：通过对我院近10年422例ARF患者临床资料的回顾性研究，应用二值多元Logistic回归和线性回归分析对影响ARF患者病死率与肾脏预后的危险因素进行分析。结果：在32项观察因素中发现低血压、昏迷、消化道出血、呼吸衰竭、肝衰竭、心力衰竭、肿瘤、败血症是患者病死率相关的危险因素；肿瘤、呼吸衰竭、心力衰竭为影响肾功能恢复的危险因素。结论：上述危险因素是影响ARF患者病死率、导致肾功能难以恢复的原因，并与患者的近期预后密切相关。

Analysis of risk factors that influencing in-hospital mortality and renal outcome in patients with acute renal failure

Objective To analyze the risk factors influencing in-hospital mortality and renal outcome in patients with acute renal failure (ARE) . Methods 422 cases of ARF patients front 1990 to 2000 were studied retrospectively by using binary logistic regression, linear regression and discriminant analysis. Results Binary logistic regression analysis showed that gastrointestinal bleeding, hepatic failure, coma, hypotension, heart failure, malignancy , sepsis and respiratory failure were associated with increased in-hospital mortality Linear regression analysis showed that malignancy, heart failure and respirators' failure (P <0. 05) were significantly associated with the adverse outcome of renal function when evaluated at the time of renal failure over 60 days( P < 0. 05) . Discriminant analysis showed that 86. 7% of the original grouped cases were correctly classified. Conclusion Gastrointestinal bleeding, hepatic failure, coma, hypotension, heart failure, malignancy sepsis and respiratory failure are the predictive factors on prognosis of ARF patients, and malignancy, heart failure and respiratory failure are significantly associated with the adverse outcome of renal function.