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目的:通过比较产后出血患者中发生急性肾损伤(AKI)与non-AKI患者的产后尿蛋白,探讨尿蛋白与AKI的关系。方法:回顾分析2012年1月1日至2015年12月31日于中国医科大学附属盛京医院住院的387例孕产妇的基本信息。采用尿试纸实验确定尿蛋白的含量,其结果以阴性、+-、+、++、+++、++++表示。采用t检验、χ~2检验及logistic回归分析用于检验尿蛋白与AKI之间的关系。结果:387例孕产妇的AKI总发生率约为24.8%,其中AKI-1级:60.4%;AKI-2级:15.6%;AKI-3级:24.0%。logistic回归分析显示,尿蛋白是AKI发生的独立危险因素,且随着尿蛋白等级的增加,AKI的发生率及AKI的等级随之增加(尿蛋白+-/+:OR=8.666,95%CI为4.215~17.817;尿蛋白++~++++:OR=52.970,95%CI为20.466~137.095,P<0.05)。结论:产后出血的孕产妇中,产后尿蛋白水平与AKI发生密切相关,且即使体内肌酐及尿量均未发生改变时,尿蛋白的出现可能预示着早期急性肾损伤的发生。
Objective: To investigate the relationship between urinary protein and AKI by comparing postpartum urinary protein in patients with acute kidney injury (AKI) and non-AKI in postpartum hemorrhage. Methods: A retrospective analysis of January 1, 2012 to December 31, 2015 in Shengjing Hospital Affiliated to China Medical University 387 cases of maternal basic information. Urine protein content was determined experimentally with urine test strips and the results were negative, + -, +, ++, +++, ++++. T test, χ ~ 2 test and logistic regression analysis were used to test the relationship between urinary protein and AKI. Results: The total incidence of AKI in 387 pregnant women was about 24.8%, of which AKI-1 grade was 60.4%, AKI-2 grade was 15.6% and AKI-3 grade was 24.0%. Logistic regression analysis showed that urinary protein was an independent risk factor for AKI. With the increase of urinary protein level, the incidence of AKI and AKI level increased (urinary protein + - / +: OR = 8.666, 95% CI Was 4.215 ~ 17.817; urinary protein ++ ~ ++++: OR = 52.970, 95% CI was 20.466 ~ 137.095, P <0.05). Conclusion: The postpartum urine protein level is closely related to the occurrence of AKI in the postpartum hemorrhage pregnant women, and the presence of urinary protein may indicate the occurrence of early acute kidney injury even though no change of body creatinine and urine output.