中国体外循环杂志2025，Vol.23Issue(4)：318-323,6.DOI:10.13498/j.cnki.chin.j.ecc.2025.04.07
连续阴离子间隙检测与接受连续性肾脏替代治疗的危重患者死亡率的相关性
Association of continuous anion gap testing with mortality in critically ill patients receiving continuous renal replacement therapy
摘要
Abstract
Objective To investigate the correlation between continuous anion gap(AG)detection and 28-day mortality in critically ill patients undergoing continuous renal replacement therapy(CRRT).Methods A retrospective study was conducted on 143 critically ill patients with acute kidney injury who underwent CRRT in our intensive care unit from March 2021 to September 2024.According to the 28-day survival outcome,all patients were divided into death group and survival group.AG levels were monitored before CRRT(preCRRT)and 24 h after CRRT(postCRRT 24 h),and △AG(preCRRT-postCRRT 24 h AG)changes were recorded.Results According to the 28-day overall survival data,all participants were divided into a survival group(n=68)and a death group(n=75).The median follow-up time from ICU admission to discharge or death was 18.60(8.53,38.16)days.The preCRRT or postCRRT 24 h AG levels in death group was significantly higher than that in survival group(P<0.05),and △AG in death group was significantly lower than that in survival group(P<0.05).In restricted cubic spline analysis,preCRRT AG,postCRRT 24 h AG,and △AG were linearly correlated with 28 d mortality risk.After adjusting for other confounding factors,multivariate COX regression analysis showed that preCRRT AG,postCRRT 24 h AG and △AG were independent predictors of 28 d mortality risk in critically ill patients receiving CRRT(P<0.05).ROC curve analysis showed that preCRRT AG and postCRRT 24 h AG had predictive value of 0.886(95%CI:0.847-0.927)and 0.883(95%CI:0.844-0.922)for 28 d mortality risk,which was better than sequential orgen failure assessment score[0.656(95%CI:0.593-0.719)]and estimated glomerular filtration rate[0.591(95%CI:0.525-0.657)].Conclusion Higher preCRRT or postCRRT 24 h AG levels and smaller△AG were all significantly associated with an increased risk of death at 28 days in critically ill patients receiving CRRT.关键词
阴离子间隙/急性肾损伤/连续性肾脏替代治疗/ICU危重患者/死亡率Key words
Anion gap/Acute kidney injury/Continuous renal replacement therapy/Critically ill patients/Mortality rate引用本文复制引用
汤熠,陈千益,刘黎明,陈卫香..连续阴离子间隙检测与接受连续性肾脏替代治疗的危重患者死亡率的相关性[J].中国体外循环杂志,2025,23(4):318-323,6.基金项目
上海市崇明区"可持续发展科技创新行动计划"项目(CKY2018-20) （CKY2018-20）
