论文部分内容阅读
目的:探讨尿蛋白定性结果作为危重患者病情、早期肾功能损害及预后指标的可行性。方法:通过前瞻性队列研究方法,测定入ICU患者24h内最原始尿蛋白定性结果,与同期肾小球滤过率(以内生肌酐清除率Ccr表示)、血肌酐(Scr)比较;并与APACHEⅢ评分系统进行预后评估比较。结果:40例ICU危重患者中尿蛋白、Ccr、Scr阳性率分别为72.5%,60.0%,25.0%。尿蛋白定性结果与Scr、APACHEⅢ存在正相关关系,同Ccr存在负相关关系。尿蛋白阳性患者同阴性患者在病死率和多器官功能衰竭(MODS)发生率上差异无统计学意义(P>0.05),在肾功能不全发生率上差异具有统计学意义(P<0.05)。尿蛋白阳性的危重患者随阳性级别增加,其MODS发生率及病死率也增加。结论:对既往无高血压、糖尿病、肾脏疾病史的危重患者,尿蛋白定性结果与疾病的严重程度有关,阳性结果作为监测早期肾功能的指标是可行的;对于尿蛋白阳性的危重患者,随阳性级别增加,其发生MODS及死亡的可能性有可能增加。
Objective: To investigate the qualitative results of urinary protein as a critical patient’s condition, early renal dysfunction and prognosis of feasibility. Methods: According to the prospective cohort study, the qualitative results of urinary protein in 24 hours after ICU inpatients were determined, and compared with glomerular filtration rate (Ccr) and serum creatinine (Scr) Scoring system for prognosis assessment comparison. Results: The positive rates of urinary protein, Ccr and Scr in 40 ICU critically ill patients were 72.5%, 60.0% and 25.0% respectively. Urine protein qualitative results and Scr, APACHE Ⅲ there is a positive correlation between the negative correlation with Ccr. Urine protein positive patients with negative patients in the mortality and multiple organ failure (MODS) was no significant difference (P> 0.05), the incidence of renal insufficiency was significantly different (P <0.05). Urine protein positive critically ill patients with the positive level increased, the incidence of MODS and mortality also increased. CONCLUSIONS: In critically ill patients with no previous history of hypertension, diabetes and kidney disease, the qualitative results of urinary protein are related to the severity of the disease. Positive results are feasible as indicators for monitoring early renal function. For critically ill patients with positive urine protein, The positive level increased, its occurrence of MODS and the possibility of death is likely to increase.