Zhi De-Yuan, Lin Jin, Zhuang Hai-Zhou, Dong Lei, Ji Xiao-Jun, Guo Dong-Cheng, Yang Xiao-Wei, Liu Shuai, Yue Zu, Yu Shu-Jing, Duan Mei-Li
Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Intensive Care Unit, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
J Invest Surg. 2019 Dec;32(8):689-696. doi: 10.1080/08941939.2018.1453891. Epub 2018 Apr 25.
: The objectives of this study were to examine the clinical profile of critically ill patients with septic acute kidney injury (AKI) and to investigate clinical characteristics associated with the outcome of patients. : Data from 582 critically ill patients were collected and retrospectively reviewed. Patients were divided into two groups: without AKI development and with AKI development. Baseline characteristics, laboratory, and other clinical data were compared between these two groups, and correlations between the characteristics and AKI development were examined. Patients with AKI development were further divided into two groups according to the survival outcome, and variables associated with the outcome were determined. : AKI was developed in 54.12% ( = 315) of patients, and these patients had blood pressure, SOFA score, APACHE II score, GCS, and various blood chemistry and hematology characteristics significantly different from the patients without AKI. Demographic characteristics (e.g. age and weight) were comparable between the two groups of patients. Among the 315 patients with AKI, 136 of them died during the study period. Multivariate logistic regression analysis revealed that the outcome of patients was associated with lung infection, coagulation system dysfunction, infection, and use of various treatments (epinephrine, norepinephrine, and the use of mechanical ventilation) after AKI development. : AKI occurred in approximately half of the critically ill patients admitted to ICU. The site and type of infections, as well as the use of vasopressor agents, were associated with the outcome.
本研究的目的是检查脓毒症急性肾损伤（AKI）重症患者的临床特征，并调查与患者预后相关的临床特征。收集了582例重症患者的数据并进行回顾性分析。患者分为两组：未发生AKI组和发生AKI组。比较两组患者的基线特征、实验室检查及其他临床数据，并检查这些特征与AKI发生之间的相关性。根据生存结局将发生AKI的患者进一步分为两组，并确定与结局相关的变量。54.12%（n = 315）的患者发生了AKI，这些患者的血压、序贯器官衰竭评估（SOFA）评分、急性生理与慢性健康状况评分系统II（APACHE II）评分、格拉斯哥昏迷量表（GCS）以及各种血液化学和血液学特征与未发生AKI的患者有显著差异。两组患者的人口统计学特征（如年龄和体重）具有可比性。在315例发生AKI的患者中，136例在研究期间死亡。多因素逻辑回归分析显示，患者的结局与肺部感染、凝血系统功能障碍、感染以及AKI发生后使用的各种治疗（肾上腺素、去甲肾上腺素和机械通气的使用）有关。入住重症监护病房（ICU）的重症患者中约有一半发生AKI。感染部位和类型以及血管活性药物的使用与结局有关。
