摘要
目的研究颅脑损伤后急性肾损伤（AKI）的发病情况及其危险因素。方法采用前瞻性队列研究，收集我院2008年1月1日至2010年1月1日收治的颅脑损伤患者的临床资料。颅脑损伤诊断：明确的脑外伤病史，头颅CT证实，格拉斯哥昏迷（GCS）评分。AKI诊断标准：48h内Scr上升≥26．4μmol／L或较基础值增加≥50％；和（或）尿量〈0．5ml·kg。·h^-1达6h。应用多因素回归方法筛选颅脑损伤患者发生AKI的危险因素。结果791例患者颅脑损伤后AKI的发病率为39．4％，发生AKI的颅脑损伤患者住院病死率为27．9％，其死亡风险较非AKI患者增加5．065倍（P〈0．01）。GCS评分≤8分（重型）者AKI的发病率为69．7％，显著高于中型和轻型两组（P〈0．01）。多因素非条件Logistic回归分析显示，GCS评分低（≤8分）、低血压（收缩压〈90mmHg）、年龄（每增加10岁）、男性是颅脑损伤患者发生AKI的独立危险因素，OR值分别为2．932、2．176、1．789、1．544。结论AKI是颅脑损伤患者常见的并发症。GCS评分低、低血压、高龄、男性是颅脑损伤患者发生AKI的独立危险因素。
Objective To investigate the incidence and risk factors of acute kidney injury （AKI） after craniocerebral injury. Methods A single cohort of 791 patients who suffered from craniocerebral injury from January 2008 to January 2010 in the Second Hospital of Lanzhou University were prospectively analyzed. Craniocerebral injury was defined according to definite medical history of craniocerebral injury, the verification of CT and Glasgow coma scale （GCS） score. AKI was defined as a relative 50% increase or an absolute increment of 26.4 I^mol/L in Scr within 48 hours and/or urine volume 〈0.5 ml＂ kg^-1＂ h^-1 up to 6 h. Multivariate Logistic regression analysis was used to evaluate possible risk factors associated with post-craniocerebral injury AKI. Results Of the 791 patients, the incidence of AKI was 39.4%. In hospital mortality of AKI patients was 27.9%, which was 5.065 times of non-AKI patients （P〈0.01）. The incidence of AKI in patients with lower GCS score （~8 score,heavy group）was 69.7%, which was significantly higher as compared to moderate and mild groups （P〈0.01）. Unconditional multivariate Logistic regression analysis revealed that lower GCS score （~8 score）, hypotension （systolic pressure〈90 mm Hg）, elderly and male were the independent predictors of AKI episodes, the corresponding OR values were 2.932, 2.176, 1.789, 1.544 respectively. Conclusions AKI is a common comphcation after craniocerebral injury. Lower GCS score, hypotension, elderly and male are the independent risk factors of AKI in patients after craniocerebral injury.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2012年第10期765-768,共4页
Chinese Journal of Nephrology
关键词
颅脑损伤
肾功能不全
急性
格拉斯哥昏迷评分
Craniocerebral trauma
Renal insufficiency, acute
Glasgow coma scale score
