论文部分内容阅读
目的分析极低出生体重儿(VLBWI)急性肾损伤(AKI)的发病情况、危险因素和预后。方法将87例VLBWI分为无AKI组54例和AKI组33例。参照急性肾损伤网络(AKIN)诊断标准进行AKI分期、危险因素及预后的判断。结果符合AKI诊断标准33例(37.9%)中,AKI1期14例(16.1%),2期10例(11.5%),3期9例(10.3%)。AKI组患儿病死率明显高于无AKI组患儿(51.5%vs.5.6%)(P<0.01)。病死率:AKI 1期组21.4%,2期组60.0%,3期组88.9%,均高于无AKI组的5.6%(P<0.01)。多因素Logistic回归分析显示,围生期窒息、医院感染败血症、呼吸窘迫综合征和机械通气≥3d是VLBWI发生AKI的独立危险因素。结论 VLBWI有较高的AKI发生率,AKIN分期对VLBWI发生AKI的早期诊断和判断预后有重要的指导意义。
Objective To analyze the incidence, risk factors and prognosis of acute kidney injury (AKI) in very low birth weight infants (VLBWI). Methods 87 cases of VLBWI were divided into no AKI group 54 cases and AKI group 33 cases. Acute kidney injury (AKIN) was used to diagnose the AKI staging, risk factors and prognosis. Results According to the AKI diagnostic criteria, 33 cases (37.9%) had AKI1 in 14 cases (16.1%), 2 cases in 10 cases (11.5%) and 3 cases (10.3%) in 3 cases. The mortality rate in children with AKI was significantly higher than that in children without AKI (51.5% vs.5.6%) (P <0.01). Case fatality rate was 21.4% in AKI stage 1 group, 60.0% in stage 2 group and 88.9% in stage 3 group, both of which were higher than 5.6% of those without AKI group (P <0.01). Multivariate Logistic regression analysis showed that perinatal asphyxia, nosocomial sepsis, respiratory distress syndrome and mechanical ventilation ≥3 days were independent risk factors for AKI in VLBWI. Conclusion VLBWI has a high incidence of AKI, AKIN staging of VLBWI AKI early diagnosis and prognosis of an important guide.