连续性肾脏替代治疗I型心肾综合征患者的临床分析.doc

连续性肾脏替代治疗I型心肾综合征患者的临床分析 李军辉 盛晓华 程东生 费杨 刘玉梅 范瑛 汪年松 作者单位：215006 苏州，苏州大学医学部（李军辉）；200233 上海，上海交通大学附属第六人民医院肾内科（李军辉 盛晓华 程东生 费杨 刘玉梅 范瑛 汪年松） 基金项目：国家自然基金面上项目(、上海市卫生和计划生育委员会课题（201440531）、上海市科委重大课题（11DZ1973103）科研基金资助 通讯作者：盛晓华 xiaohuasheng@ 汪年松 wangniansong2012@163.com 【摘要】：目的 分析行连续性肾脏替代治疗（CRRT）的I型心肾综合征（CRS）患者的临床特征及预后。 方法 选择上海交通大学附属第六人民医院2009年2月-2014年9月住院行CRRT的I型CRS患者35例，收集患者的临床资料，回顾性分析I型CRS患者的预后及相关危险因素。 结果 35例I型CRS患者中，AKI 2期7例(20%)，AKI 3期28例(80%), 平均器官衰竭数为3.6个，APACHE II评分为24.9分。存活17例(48.6%)，死亡18例(51.4%)，两组比较，在年龄、心功能分级、平均器官衰竭数目、APACHE II评分、平均动脉压、平均血小板体积(MPV)、血尿素氮、血糖和升压药物应用等方面差异均有统计学意义(P＜0.05)。 结论 需行CRRT的I型CRS的预后差，与年龄、APACHE II评分及MPV等有关，应引起足够重视。 【关键词】 连续性肾脏替代治疗；I型心肾综合征；住院 Clinical analysis of continuous renal replacement therapy for patients with cardiorenal syndrome type 1 LI Junhui, SHENG Xiaohua, CHENG Dongsheng, FEI Yang, LIU Yumei, FAN Ying, WANG Niansong. 　School of Medicine, Soochow University, Suzhou, Jiangsu 215006, China; Department of Nephrology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai 200233, China Corresponding author : SHENG Xiaohua(E-mail: xiaohuasheng@) and WANG Niansong(E-mail: wangniansong2012@163.com ). 【Abstract】 Objective The aim of this study was to analyze the risk factor and prognosis of continuous renal replacement therapy(CRRT)for patients with cardiorenal syndrome type 1(type 1 CRS )．Methods We recruited 35 type 1 CRS patients in our hospital from February 2009 to September 2014. All the patients received CRRT. Clinical data of adult patients were retrospectively analyzed. Results In the 35 patients who received CRRT, the percentage of stage II, stage III AKI were 20% and 80%, respectively. The average number of organ failure was 3.6. The score of APACHE II was 24.9. Of the 35 patients in the period of investigation, 17 patients (48.6%) were survived and 18 patients (51.4%) were dead. There were significant difference in age, cardiac function grading, average number of organ failure,?the sc