480例急性肾损伤住院患者临床分析

目的探讨急性肾损伤住院患者的病因构成、临床转归及住院死亡率等流行病学特征。方法回顾性分析64058例住院患者急性肾损伤的发生情况，并分析其临床特征、导致肾功能受损的原因及临床转归等。采用logistic回归方法分析与急性肾损伤患者死亡相关的因素。结果2006年1月1日～2008年12月31日64058例住院患者中急性肾损伤患者480例，发生率为0．75％。急性肾损伤患者住院死亡率为23．33％，而3年的总住院死亡率为1．49％。急性肾损伤的病因以肾前性和肾实质性为主，年长者居多。logistic回归分析结果表明，影响急性肾损伤患者死亡的因素是脏器衰竭数目和年龄，OR值分别为12．268和1．488，95％可信区间分别为7．639～19．701和1．030～2．151。结论脏器衰竭数目的增加和高龄是急性肾损伤患者死亡的危险因素。医护人员认知水平的提高、动态肾功能检测是提高早期诊断率的关键，多科室协同综合治疗措施的及时介入、保护重要脏器功能有助于改善预后。

Clinical analysis of 480 patients with acute kidney injury in hospitalized patients

Objective To investigate the etiological constitution ratio,clinical outcomes and hospitalized mortality of acute kidney injury （AKI） in hospitalized patients in a pandocheum. Methods Retrospectively analyzed AKI occurrence in 64058 hospitalized patients. Collected the clinical information, such as baseline materials, etiology and clinical outcomes. Logistic regression analysis was applicated to analyze the factors that impacted the patients mortality of AKI. Results The overall incidence of AKI was 0.75% in the 64058 hospitalized patients. The in-hospital mortality was 23.33% in patients with AKI. Meanwhile, the 3-year total mortality was 1.49% in all the hospitalized patients. Prerenal and parenchyma impairment were the main causes of AKI. Eider patients were more susceptive to AKI. The muhivariable logistic regression analysis indicated that the number of dysfunctional organ [ OR 12. 268,95% CI （ 7. 639, 19. 701 ） ] and age [ OR 1. 488,95% CI （ 1. 030,2. 151 ） ] were correlated with poor prognosis. Conclusions In-hospital mortality is increased significantly in patients with AKI. The number of dysfunctional organ and age were the risk factors for mortality of AKI. It is important to improve the ability of early diagnosis of AKI for doctors and nurses. Early intervention and protection from multiple organ failure are the effective ways to improve prognosis of AKI.