中国循证儿科杂志2011，Vol.6Issue(4)：275-279,5.DOI:10.3969/j.issn.1673-5501.2011.04.006
重度窒息新生儿发生急性肾损伤回顾性分析
Retrospective analysis of acute kidney injury in neonates with severe asphyxia
摘要
Abstract
Objective The purpose of this study was to analyze the features and short-term outcomes in severe asphyxiated neonates with or without acute kidney injury ( AKI ) in order to validate the applicability of the criteria and classification of AKI.Methods Severe asphyxiated neonates with SCr values twice and records of urine output were enrolled and retrospectively analyzed.The criteria proposed by Acute Kidney Injury Network were applied to diagnose the occurence of AKl.All neonates enrolled were divided into two groups, AKI group and non-AKI group.Clinical features and short-term outcomes were compared between the two groups.Results A total of 17/30 ( 56.7％ ) patients were diagnosed to he with AKI.the rest of 13/30 patients who did not meet the criteria of AKI were divided into non-AKI group.Ten of 17 AKI patients only fulfilled urine criteria but not SCr criteria, 7 patient fulfilled both criteria.For 13 out of 17 patients in AKI group, the grade of the classification by urine output was higher than those calssified by creatinine criteria.Three patients had the same urine stage as SCr stage, 3 had higher urine stage than SCr stage and 1 had lower urine stage than SCr stage.Seven patients with high SCr( SCr＞133 μmol · L-1 ) and fulfilled the diagnostic criteria of acute renal failure.The proportion of bad prognosis ( 29.4％ v.s 15.4％ for AKI group and non-AKI group,P = 0.368 ) and the average days of hospital stay [( 14.7 ± 13.9 ) d v.s ( 13.7±9.6 ) d, P = 0.83]were not statistically different between the AKI and non-AKI groups.According to the creatinine criteria, there were 7 neonates diagnosed as AKI, and the prognosis was statistically different between AKI-scr group and non AKI-scr group ( P = 0.016 ).Conclusions More than a half of severe asphyxia neonates reached the criteria of AKI.The criteria by measuring urine output seemed more sensitive than that by detecting the increase of serum creatinine.The increase of serum creatinine might suggest bad prognosis.Studies with large sample size and long term follow-up are needed for further investigation on AKI in neonates.关键词
急性肾损伤/急性肾功能衰竭/重度窒息/新生儿/血清肌酐/尿量Key words
Acute kidney injury/ Acute renal failure / Severe asphyxia/ Neonates / Serum creatinine / Urine output引用本文复制引用
刘晓宇,张欣,王颖,丁洁..重度窒息新生儿发生急性肾损伤回顾性分析[J].中国循证儿科杂志,2011,6(4):275-279,5.基金项目
北京大学第一医院2010年度院内青年基金 （）
