中国临床医学2024，Vol.31Issue(3)：451-456,6.DOI:10.12025/j.issn.1008-6358.2024.20240401
脓毒症急性肾损伤患者早期肾功能恢复的影响因素分析
Analysis of influence factors of early renal function recovery in patients with sepsis-associated acute kidney injury
摘要
Abstract
Objective To analyze the factors influencing the early recovery of renal function in patients with sepsis-associated acute kidney injury(SA-AKI).Methods A retrospective analysis was conducted on 86 SA-AKI patients treated in the Intensive Care Unit at Zhongshan Hospital,Fudan University from January 2021 to December 2022,who met both the Sepsis 3.0 diagnostic criteria and the AKI diagnostic standards.Patients were divided into a recovery group and a non-recovery group based on whether their renal function recovered within 7 days after AKI onset.Clinical data and laboratory tests of patients were compared between the two groups.Univariate and multivariate logistic analyses were used to identify risk factors affecting renal function recovery in SA-AKI patients,and ROC curve was utilized to evaluate the predictive value of these factors for early renal function recovery in SA-AKI patients.Results The renal function of 37(43.02％)patients recoveried.Compared with the recovery group,the renal replacement therapy rate,in-hospital mortality and 28-day mortality of patients in the non-recovery group were higher(P＜0.001).The multivariate logistic analysis showed that age,APACHE Ⅱ score,urine output,urine neutrophil gelatinase-associated lipocalin(NGAL),and norepinephrine dose were independent related factors affecting renal function recovery in SA-AKI patients(P＜0.05).The final model logit(P)=-4.091+0.001×urine NGAL-0.001 Xurine volume+0.040 ×age+0.073 × APACHE Ⅱ score+1.906 × norepinephrine dose.The AUC of model predicting early SA-AKI recovery was 0.823,with 73.5％of sensitivity,and 81.1％of specificity.Conclusions In SA-AKI patients,age,APACHE Ⅱ score,urine output,urine NGAL,and the dose of norepinephrine independently affect early renal function recovery,and the combined assessment of these indicators has predictive value for the early renal recovery in these patients.关键词
脓毒症/急性肾损伤/肾功能恢复/影响因素Key words
sepsis/acute kidney injury/renal function recovery/influence factor分类
医药卫生引用本文复制引用
潘思梦,姚瑶,林世龙,钟鸣,顾准咏,宋洁琼..脓毒症急性肾损伤患者早期肾功能恢复的影响因素分析[J].中国临床医学,2024,31(3):451-456,6.基金项目
复旦大学附属中山医院临床研究专项基金(ZSLCYJ202339).Supported by Special Fund for Clinical Research of Zhongshan Hospital,Fudan University(ZSLCYJ202339). （ZSLCYJ202339）
