【摘 要】
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目的 脓毒症继发急性损伤是脓毒症患者死亡的重要原因之一,凝血变化是急性肾损伤重要因素.本研究旨在筛选脓毒症过程中同急性肾损伤相关的凝血指标.方法 本研究收集外科、急诊及呼吸重症监护室的脓毒症患者,纳入132例脓毒症患者,其中合并急性肾损伤64例,非急性肾损伤68例.收集各组患者一般资料及入ICU第1个24h内各项实验室指标,利用Logistic回归分析及Cox回归分析进行统计学分析.结果 AKI组与非AKI组相比,抗凝血酶Ⅲ(P=0.007)显著降低,D-二聚体则显著升高(P=0.006).二分类变量Lo
【机 构】
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首都医科大学附属北京朝阳医院呼吸与危重症医学科,北京市呼吸疾病研究所,北京市呼吸与危重症诊治工程技术研究中心,北京 100016;航天总医院综合 ICU,北京 100008;首都医科大学附属北京朝阳医
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目的 脓毒症继发急性损伤是脓毒症患者死亡的重要原因之一,凝血变化是急性肾损伤重要因素.本研究旨在筛选脓毒症过程中同急性肾损伤相关的凝血指标.方法 本研究收集外科、急诊及呼吸重症监护室的脓毒症患者,纳入132例脓毒症患者,其中合并急性肾损伤64例,非急性肾损伤68例.收集各组患者一般资料及入ICU第1个24h内各项实验室指标,利用Logistic回归分析及Cox回归分析进行统计学分析.结果 AKI组与非AKI组相比,抗凝血酶Ⅲ(P=0.007)显著降低,D-二聚体则显著升高(P=0.006).二分类变量Logistic回归显示,D-二聚体与抗凝血酶Ⅲ为脓毒症继发AKI的危险因素,OR值分别为3.018(95％CI:1.127～8.083)和2.89(95％CI:1.181～7.070),P<0.05.利用Cox回归分析显示仅有D-二聚体同病死率相关,HR值1.347(95％CI:1.081～1.677),P=0.008.结论 D-二聚体和抗凝血酶 ≠是脓毒症继发AKI发生的独立危险因素.D-二聚体升高同脓毒症继发AKI的28d病死率高相关.
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