急性肾损伤合并消化道出血危险因素分析.docVIP

PAGE PAGE 1 急性肾损伤合并消化道出血危险因素分析 　　【摘要】目的观察急性肾损伤合并急性消化道出血患者临床特征、发病情况、病因、疾病危险因素及预后。方法回顾性总结分析了山西省人民医院近5年确诊急性肾损伤512例患者，对其消化道出血的临床危险因素、住院病死率及相关独立预测因子进行研究。结果急性肾损伤合并消化道出血53例，上消化道出血45例，临床严重出血15例，消化道出血独立危险因素是心功能衰竭、机械通气、血小板减少、慢性肝病、肝硬化及急性肾损伤3期的患者。伴有消化道出血住院病死率52.8%，不伴有消化道出血患者病死率22.2%。伴有消化道出血病死率明显高于其他患者。结论消化道出血是急性肾损伤常见合并症。而且以上消化道出血更常见。消化道出血与急性肾损伤病死率增加密切相关。肾脏以及肾脏以外其他危险因素与消化道出血发生有关。 　　【关键词】急性肾损伤；消化道出血；危险因素 　　AnalysisonriskfactorsacutekidneyinjurycomplicatedbyacutegastrointestinalhemorrhageWENTao，LUOYan-kun，LIUGao-hong，ZHANGCai-xiang，YANCheng-yen.NephrologyDepartment，ShanxiProvincePeopleHospial，TaiYuan030012，China 　　Correspondingauhor：WENTao，Email：wentao580116@ 　　【Abstract】ObjectiveFewprospectivedataarecurrentlyavailableonacutegastrointestinalhemorrhage（AGIH）asacomplicationinacutekidneyinjury（AKI）.Theaimofthepresentstudywastofindoutclinicalcharacteristics，incidence，etiology，riskfactors，andoutcomeofAGIHinpatientswithAKI.MethodsWeperformedaprospectivestudyonaninceptionecohprtof512patientsadmittedforAKIinourhospital.Dataonclinicalriskfactorsforbleeding，frequencyofoccurrenceofAGIH，in-hospitalmortalitywerecollected，andindependentpredictorsofAGIHwereidentified.ResultsAtotalof53patientshadAGIHasacomplicationofAKI，and45wereupperAGIH.Fifteenpatientshadclinicallyseverebleeding.IndependentbaselinepredictorsofAGIHwereseverityofillness，cardiacfailure，mechanicalventilation，lowplateletcount，chronichepaticdisease，lievercirrhosis，severeAKI.In-hospitalmortalitywas52.8%inpatientswithAGIH，and22.2%intheotherpatients.AGIHwassignificantlyassociatedwithanincreaseinhospitalmortality.ConclusionsAGIHarefrequentcomplicationsofAKI.Inthisclinicalcondition，AGIHismoreoftenduetouppergastrointestinalbleedingandisassociatedwithasignificantlyincreasedriskofdeath.BothrenalandextrarenalriskfactorsarerelatedtotheoccurrenceofAGIH. 　　【Keywords】Acutekidneyinjury；Acutegastrointestinalhemorrhage；Riskfactor 　　尽管急性肾损伤（acutekidneyinjury，AKI）的诊断和治疗有很大的改进，但病死率仍居高不下，尤其合并急性消化道出血住院病死率的风险明显增加，是严重威胁AKI患者预后的常见合并症。AKI合并上消化道出血更为常见，占8%