167例急性肾功能衰竭患者预后的临床因素分析

目的：探讨影响急性肾功能衰竭（肾衰）患者预后的重要临床因素。方法：采用多元分析方法；回顾分析１６７例急性肾衰患者的１８个临床指标，从中筛选出对预后有重要影响的临床因素；建立判别函数。结果：急性心肌梗死（心梗）或心力衰竭（心衰）、昏迷、辅助呼吸、严重感染及透析前２４小时输液量与预后密切相关，由急性心梗或心衰、昏迷和透析前２４小时输液量３个变量组成判别函数，其阳性预测值和敏感度分别为８２．１％和８０．９％。结论：预防并及时治疗心、肺、脑器官衰竭和严重感染，严格遵循“量出为入，宁少勿多”的输液原则，是减少急性肾衰患者死亡的重要环节；判断函数有助临床医师估计患者预后并采取相应措施。

Predictors analysis in 167 patients with acute renal failure

Objective:To define prognostic factors in patients with acute renal failure(ARF). Methods :Eighteen clinical variables were retrospectively studied by multivariate analysis in 167 paitents. Results :Five variables (acute myocardial infarction or acute heart failure,coma,assisted ventilation,severe infection and number of transfusions before dialysis) contributed to prognosis in the overall analysis.Using a function derived by stepwise discriminating analysis,death could be predicted with a positive predictive value of 82 1% and a sensitivity of 80 9%.Conclusions:Prevention and early treatment of the failure of vital organs and sepsis,and strict compliance with principles of transfusions,are pivotal for reducing mortality in patients with ARF.The discriminating function is helpful for clinicians to evaluate outcome of patients with this syndrome.