老年人群肺炎住院患者急性肾损伤的发病率和危险因素

吴子瑜; 何岩燕; 周振寿; 郭太林

文章摘要

吴子瑜，何岩燕，周振寿，郭太林.老年人群肺炎住院患者急性肾损伤的发病率和危险因素[J].实用中西医结合临床,2023,23(5):1-4,50

老年人群肺炎住院患者急性肾损伤的发病率和危险因素

Incidence and Risk Factors of Acute Kidney Injury in Elderly Patients Hospitalized with Pneumonia

DOI：

中文关键词: 急性肾损伤社区获得性肺炎老年患者 CURB-65评分

英文关键词: Acute kidney Injury Community acquired pneumonia CURB-65

基金项目:福建省卫生健康委员会基金计划项目（编号：2019-1-22）

作者	单位
吴子瑜，何岩燕，周振寿，郭太林	福建省立医院老年科；福建中医药大学附属人民医院影像科

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中文摘要:

目的：分析探讨社区获得性肺炎（Community Acquired Pneumonia, CAP）老年患者急性肾损伤（Acute Kidney Injury, AKI）的发病率和相关危险因素。方法：回顾性分析2018年1月至2020年12月福建省立医院老年科≥60岁的老年患者诊断为CAP的临床资料，将其分为AKI组和非AKI组。比较两组患者基线特征和临床资料的差异，评价CAP老年患者的AKI发病率；应用Logistic回归模型分析AKI相关危险因素。结果：入选资料完整的326例CAP老年患者中，年龄（69.8±17.5）岁，男性218例（66.87%），AKI患者135例（41.41%）；AKI组合并慢性肾脏病和冠状动脉疾病比例、血尿酸水平、血胆红素、血乳酸脱氢酶、CAP患者CURB-65评分、血肌酐、血尿素氮均明显高于非AKI组，血白蛋白和总蛋白均明显低于非AKI组，差异有统计学意义（P＜0.05）；经多因素Logistic回归分析显示高血胆红素、低血白蛋白、高CURB-65评分可能是老年患者CAP出现AKI的独立危险因素。结论：CAP住院的老年患者中AKI的发生率41.41%，高血胆红素、低血白蛋白、高CURB-65评分可能是CAP老年患者AKI的独立危险因素。临床应警惕CAP老年患者AKI的预防和早期发现。

英文摘要:

Objective: To analyze the incidence and risk factors of acute kidney injury(AKI) in elderly patients with community acquired pneumonia(CAP). Methods: The clinical data of elderly patients ≥60 years old diagnosed as CAP in the department of Geriatrics of Fujian Provincial Hospital from January 2018 to December 2020 were analyzed retrospectively. They were divided into AKI group and non-AKI groups to compare the differences in baseline characteristics and clinical data between the two groups, to evaluate the incidence of AKI in elderly patients with CAP. Logistic regression model was used to analyze the risk factors associated with AKI. Results: Among 326 elderly patients with CAP with complete data, aged (69.80±17.50) years old, 218 male(66.87%) and 135 AKI patients(41.41%). Compared to non-AKI group, the proportion of CKD and CAP, uric acid levels, serum bilirubin, serum LDH, CURB-65 scores of CAP patients, serum creatinine and BUN were significantly increased in the AKI group; blood albumin and total protein were decreased in the AKI group(P＜0.05). Multiple Logistic regression analysis showed that higher bilirubin, lower albumin and higher CURB-65 score may were independent risk factors of AKI in elderly patients with CAP. Conclusion: The incidence of AKI in elderly patients hospitalized with CAP is 41.41%. High Serum bilirubin, low albumin and high CURB-65 scores may be independent risk factors of AKI in elderly patients with CAP. Clinical attention should be alert for the prevention and early detection of AKI in elderly patients with CAP.

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