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目的:评估在儿童重症病房(PICU)中治疗的新生儿发生急性肾损伤(AKI)及影响预后的相关因素。方法:对在我院PICU治疗的215例新生儿进行回顾性研究,采用KDIGO标准对患儿进行诊断与分级,根据新生儿是否发生AKI将新生儿分为AKI组(n=75)与非AKI组(n=140),收集并比较二组患者的临床资料,采用多元逻辑回归分析PCIU新生儿发生AKI的危险因素与AKI预后相关因素。结果:单因素逻辑回归分析表明,菌血症(OR=5.34,95%CI:1.37-20.33,P=0.013)、较低基线e GFR(OR=0.93,95%CI:0.89-0.97,P=0.002)与最大钠浓度(OR=1.11,95%CI:1.03-1.25,P=0.022)为新生儿发生AKI的独立相关因素。死亡率、长期LMV只与AKI(Ⅱ+Ⅲ)阶段相关(P<0.05),而LOS无论调整前后均只与AKI(Ⅱ+Ⅲ)阶段相关(P<0.05)。结论:PCIU治疗的AKI新生儿死亡率增加,菌血症、较低基线估计肾小球滤过率和最大钠浓度与急性肾损伤独立相关。
PURPOSE: To assess the incidence of acute kidney injury (AKI) in neonates treated in pediatric intensive care units (PICU) and related factors that influence prognosis. Methods: A total of 215 newborns treated with PICU in our hospital were retrospectively studied. The KDIGO criteria were used to diagnose and grade the children. Neonates were divided into AKI group (n = 75) and non-AKI group (N = 140). The clinical data of two groups were collected and compared. Multivariate logistic regression was used to analyze the risk factors of AKI in newborns with PCI and the prognostic factors of AKI. Results: Univariate logistic regression analysis showed that the incidence of bacteremia (OR = 5.34,95% CI: 1.37-20.33, P = 0.013) and lower baseline e GFR (OR = 0.93, 95% CI: 0.89-0.97, P = 0.002) and maximum sodium concentration (OR = 1.11, 95% CI: 1.03-1.25, P = 0.022) were independent risk factors for neonatal AKI. Mortality and long-term LMV were only related to stage AKI (stage II + III) (P <0.05), whereas stage LOS was only associated with stage AKI (stage II + III) before and after adjustment (P <0.05). Conclusions: AKI neonatal mortality increased with PCIU, with bacteremia, lower baseline estimates of glomerular filtration rate and maximum sodium concentration independently associated with acute kidney injury.