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目的探讨急性肾损伤(AKI)患者血浆渗透压的变化及其临床意义。方法AKI患者入院后第2天、第4天测定血钠、血钾、血肌酐、尿素氮、血糖,计算血浆渗透压,针对高渗透压血症治疗后第7天测定血浆渗透压。结果AKI患者入院第4天血浆渗透压(329.8±39.7)mOsm/L,高于第2天的(314.7±42.6)mOsm/L;第4天高渗透压血症病例61例,高于第2天的26例;经对症治疗后第7天,血浆渗透压降低为(316.5±37.3)mOsm/L,高渗透压血症病例降低为42例,68例AKI患者治疗第7天有21例好转或治愈。以上比较的差异均有统计学意义(均P<0.05)。结论血浆渗透压增高可能导致AKI,降低血浆渗透压治疗可能使AKI发生减少。
Objective To investigate the changes of plasma osmolality in patients with acute renal injury (AKI) and its clinical significance. Methods Serum sodium, serum potassium, serum creatinine, blood urea nitrogen and blood sugar were measured on the second and fourth days after admission in patients with AKI. The plasma osmolality was calculated and the osmotic pressure was measured on the 7th day after the hyperosmolarity treatment. Results The plasma osmolality of the AKI patients on day 4 was (329.8 ± 39.7) mOsm / L, higher than that of the second day (314.7 ± 42.6) mOsm / L. On the fourth day, 61 cases of hypertonic hypervascularization were higher than those of the second Day in 26 cases. On the 7th day after symptomatic treatment, the plasma osmolality decreased (316.5 ± 37.3) mOsm / L, the number of hypertonic hypervasculae was reduced to 42 cases, and in 68 cases of AKI patients, 21 cases improved on the 7th day Or cured. The above differences were statistically significant (P <0.05). Conclusions Increased plasma osmolality may lead to AKI. Decreasing plasma osmotic pressure may reduce AKI.