新疆地区单中心七年回顾性研究:妊娠相关急性肾损伤临床特征分析

    A seven-year retrospective study of a single center in Xinjiang:clinical features of pregnancy-related acute kidney injury

    • 摘要: 目的探讨新疆地区单中心妊娠相关急性肾损伤患者的流行病学特点和临床特征。方法利用新疆医科大学第一附属医院住院患者网络病历系统,回顾性分析2013年1月至2020年11月,在该院住院的妊娠期女性的临床资料。结果本研究共筛选出妊娠期急性肾损伤(pregnancyrelated acute kidney injury,PR-AKI)患者157例,总检出率为0.22%。导致PR-AKI的前3位病因分别为妊娠期高血压疾病(52.9%)、妊娠期急性脂肪肝(11.5%)、产后出血(10.2%)。单因素Logistic回归分析显示舒张压(OR=1.022,95%CI:1.005~1.040)、收缩压(OR=1.013,95%CI:1.001~1.026)、血钾(OR=1.942,95%CI:1.066~3.538)、尿素氮(OR=1.331,95%CI:1.200~1.476)、血肌酐(OR=1.033,95%CI:1.200~1.476)、总胆红素(OR=1.010,95%CI:1.001~1.019)是重症PR-AKI患者的危险因素。新生儿出生体重与母体孕周的相关系数最大,与凝血酶原时间相关系数最小。结论为减少PR-AKI的发生,在基层地区可通过倡导孕期健康生活方式,定时规范全面产检,完善高危孕产妇筛查3方面进行干预,减少不良妊娠结局。

       

      Abstract: Objective To explore the epidemiological and clinical characteristics of pregnancyrelated acute kidney injury(PR-AKI)at a single center in Xinjiang.Methods Through accessing the inpatient network case system of First Affiliated Hospital of Xinjiang Medical University,the authors retrospectively reviewed clinical data of pregnant women hospitalized from January 2013 to November 2020.Results A total of 157 PR-AKI patients were recruited with an overall detection rate of 0.22%. The top three causes of PR-AKI were hypertension in pregnancy(52.9%),acute fatty liver of pregnancy(11.5%)and postpartum hemorrhage(10.2%). Single factor Logistic regression analysis revealed that diastolic blood pressure(OR=1.022,95%CI:1.005-1.040),systolic blood pressure(OR=1.013,95%CI:1.001-1.026),serum potassium(OR=1.942,95%CI:1.066-3.538),urea nitrogen(OR=1.331,95%CI:1.200-1.476),blood creatinine(OR=1.033,95%CI:1.200-1.476)and total bilirubin(OR=1.010,95%CI:1.001-1.019)were risk factors for severe PR-AKI. The correlation coefficient between neonatal birth weight and maternal gestational age was the largest while correlation coefficient with prothrombin time was the smallest.Conclusion For lowering the incidence of PR-AKI at grassroots areas,clinicians may strive to promote healthy lifestyles during pregnancy,conduct regular and comprehensive obstetric examinations and perfect screening of high-risk pregnant women to reduce adverse pregnancy outcomes.

       

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