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医学临床研究  2020, Vol. 37 Issue (9): 1323-1325    DOI: 10.3969/j.issn.1671-7171.2020.09.014
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连续性肾脏替代治疗重症急性肾损伤患者的疗效
陈锐
广东省中山市人民医院急诊监护室,广东 中山 528400
Efficacy of Continuous Renal Replacement Therapy in Patients with Severe Acute Kidney Injury
CHEN-Rui
Emergent Intensive Care Unit, People's Hospital of Zhongshan City, Zhongshan, 528400, Guangdong,China
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摘要 【目的】 探讨连续性肾脏替代治疗(CRRT)重症急性肾损伤(AKI)患者的疗效及对相关指标变化的影响。【方法】 92例行CRRT的重症AKI患者,以患者入ICU后28 d 病死率为主要终点,根据患者预后分为生存组42例和死亡组50例。观察并比较两组疗效及相关指标变化。【结果】 生存组住院时间、住ICU时间明显高于死亡组,且差异有显著性(P<0.05)。生存组未恢复率为26.19%(11/42),明显低于死亡组的76.00%(38/50),部分恢复率为47.62%(20/42)明显高于对照组的12.00%(6/50)(P<0.05)。CRRT开始前生存组平均动脉压(MAP)、尿量明显高于死亡组,平均血小板容积(MPV)、红细胞分布宽度(RDW)低于死亡组(P<0.05)。CRRT结束后,生存组MPV、降钙素原(PCT)及胱抑素C(Cys-C)明显低于死亡组,血小板计数(PLT)、尿量明显高于死亡组(P<0.05)。生存组CRRT治疗前后, MPV差值、尿量明显高于死亡组,Cys-C差值明显低于死亡组(P<0.05)。Logistics多因素回归分析显示,CRRT治疗前MAP、MPV及治疗后Cys-C是影响重症AKI患者预后的独立因素。【结论】 重症AKI患者接受CRRT,高MAP水平有利于患者预后,MPV水平升高及Cys-C升高可作为患者病死率的独立危险因素。
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陈锐
关键词 急性肾损伤/治疗肾替代疗法    
Abstract【Objective】 To investigate the efficacy of continuous renal replacement therapy (CRRT) in patients with severe acute kidney injury (AKI).【Methods】 A total of 92 patients with severe AKI underwent CRRT in our hospital between March 2016 and August 2017 were retrospectively reviewed. Patients were divided into the survival group (n=42 cases) and the death group (n=50 cases) according to the outcomes. The mortality was the main endpoint at 28 days after ICU admission. The The efficacy and related index changes were observed and compared. 【Results】 The hospital stay and ICU stay in the survival group were significantly longer than those in the death group (P<0.05). The unrecovered rate in the survival group was significantly lower than that in the death group (26.19% vs. 76.00%), while the partial recovery rate in the survival group was 57.62% (20/42),which was significantly higher than that in the control group (12.00%, 6/50). The difference was statistically significant (P<0.05). Before the start of CRRT, the MAP and urine volume of the survival group were significantly higher than those of the death group, while the MPV and RDW were significantly lower than those of the death group (P<0.05). After the CRRT, the MPV, PCT and Cys-C of the survival group were significantly lower than those of the death group, and PLT and urine volume were significantly higher than those of death group (P<0.05). Before and after CRRT treatment, the MPV and urine volume in the survival group were significantly higher than those in the death group, while its Cys-C was significantly lower than that in the death group (P<0.05). The multivariate regression analysis showed that preoperative MAP, MPV and postoperative Cys-C were independent factors influencing the prognosis of patients with severe AKI.【Conclusion】 High MAP level is beneficial to the prognosis of severe AKI patients during CRRT.The elevated MPV and Cys-C can be used as independent risk factors for severe AKI mortality.
Key wordsAcute Kidney Injury/TH    Renal Replacement Therapy
收稿日期: 2019-03-26     
PACS:  R654.2  
引用本文:   
陈锐. 连续性肾脏替代治疗重症急性肾损伤患者的疗效[J]. 医学临床研究, 2020, 37(9): 1323-1325.
CHEN-Rui. Efficacy of Continuous Renal Replacement Therapy in Patients with Severe Acute Kidney Injury. JOURNAL OF CLINICAL RESEARCH, 2020, 37(9): 1323-1325.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.09.014     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I9/1323
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