劳力性热射病发生急性肾损伤的危险因素分析

目的:探讨影响劳力性热射病（EHS）发生急性肾损伤（AKI）的危险因素。方法:于2019年11月，回顾2015年7月至2019年9月期间收治的69例EHS患者的临床资料。收集患者的一般资料、实验室指标、入院时的格拉斯哥评分（GCS）、24小时急性生理与慢性健康评分Ⅱ（APACHE Ⅱ）、接触时间率和体力劳动强度。患者按...

Risk factors analysis of acute kidney injury in patients with exertional heatstroke

Objective To explore the risk factors of acute renal injury(AKI)in exertional heat radiation disease(EHS).Methods In november 2019,the clinical data of 69 EHS patients admitted from July 2015 to September 2019 were reviewed.The general data,laboratory indexes,Glasgow score(GCS)at admission,24-hour acute physiology and chronic health scoreⅡ(APACHEⅡ),exposure time rate and physical labor intensity were collected.According to the occurrence of AKI,the patients were divided into AKI group and non-AKI group,31 and 38 in each group.The differences of general data and laboratory indexes between the two groups were compared,and the t and Mann-Whitney U test were used to compare the two groups.The enumeration data are expressed by examples and constituent ratio(%).Independent sampleχ2 test is used for inter-group comparison,and multiple test is used for multi-sample comparison.The correlation was analyzed by linear regression.Risk factors were analyzed by Logistic regression analysis.Results At discharge,31 of 69 EHS patients developed AKI.Compared with the non-AKI group,the heart rate,white blood cell count,lactic acid,D-dimer and myoglobin were higher;MAP,platelet count and PH were lower in the AKI group.The difference was statistically significant(P<0.05).APACHEⅡscore,core temperature,time to drop to 38.5℃,contact time rate,platelet count,pH,lactic acid,D-dimer and myoglobin were all correlated with creatinine(r=0.57,0.42,0.80,0.78,0.57,0.43,0.51,0.55,0.79).APACHEⅡscore,time to drop to 38.5C,Lac and MYO are the risk factors of AKI in EHS patients.Multivariate Logistic regression analysis showed that the time required to drop to 38.5C was an independent risk factor for the occurrence of AKI.Conclusion AKI is a serious complication of EHS.EHS complicated with AKI,should be identified early and effective intervention measures should be taken.