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目的:探讨影响劳力性热射病（EHS）发生急性肾损伤（AKI）的危险因素。方法:于2019年11月，回顾2015年7月至2019年9月期间收治的69例EHS患者的临床资料。收集患者的一般资料、实验室指标、入院时的格拉斯哥评分（GCS）、24小时急性生理与慢性健康评分Ⅱ（APACHE Ⅱ）、接触时间率和体力劳动强度。患者按照是否发生AKI，分为AKI组（31人）和非AKI组（38人）。比较两组患者的一般资料及实验室指标的差别，两组间比较用n t检验和Mann-Whitney U检验。计数资料以例和构成比（%）表示，组间比较用独立样本χn 2检验；多样本间的比较用多重检验。相关性用线性回归分析。危险因素分析用logistic回归分析。n 结果:以出院为观察终点，69例EHS患者中发生AKI共31例。与非AKI组比较，AKI组的心率、白细胞计数、乳酸、D-二聚体、肌红蛋白均较高，MAP、血小板计数、PH均较低，差异均有统计学意义（n P<0.05）。患者APACHEⅡ评分、核心温度、核心温度降至38.5 ℃所需时间（Tn 降至38.5℃）、接触时间率、血小板计数、PH值、酸碱值、乳酸、D-二聚体、肌红蛋白与肌酐均相关（n r=0.57、0.42、0.80、0.78、0.57、0.43、0.51、0.55、0.79）。APACHEⅡ评分、Tn 降至38.5℃、Lac、MYO是劳力性热射病患者发生AKI的危险因素（n P<0.05）。多因素logistic回归分析显示，Tn 降至38.5℃是AKI发生的独立危险因素。n 结论:AKI是EHS的严重并发症之一，应早期识别EHS并发AKI，并进行有效的干预措施。“,”Objective:To explore the risk factors of acute renal injury (AKI) in exertional heat radiation disease (EHS) .Methods:In november 2019, the clinical data of 69 EHS patients admitted from July 2015 to September 2019 were reviewed. The general data, laboratory indexes, Glasgow score (GCS) at admission, 24-hour acute physiology and chronic health score Ⅱ (APACHE Ⅱ) , exposure time rate and physical labor intensity were collected. According to the occurrence of AKI, the patients were divided into AKI group and non-AKI group, 31 and 38 in each group. The differences of general data and laboratory indexes between the two groups were compared, and the t and Mann-Whitney U test were used to compare the two groups. The enumeration data are expressed by examples and constituent ratio (%) . Independent sample χ n 2 test is used for inter-group comparison, and multiple test is used for multi-sample comparison. The correlation was analyzed by linear regression. Risk factors were analyzed by Logistic regression analysis.n Results:At discharge, 31 of 69 EHS patients developed AKI. Compared with the non-AKI group, the heart rate, white blood cell count, lactic acid, D-dimer and myoglobin were higher; MAP, platelet count and PH were lower in the AKI group. The difference was statistically significant (n P<0.05) . APACHE Ⅱ score, core temperature, time to drop to 38.5 ℃, contact time rate, platelet count, pH, lactic acid, D-dimer and myoglobin were all correlated with creatinine (n r=0.57, 0.42, 0.80, 0.78, 0.57, 0.43, 0.51, 0.55, 0.79) . APACHE Ⅱ score, time to drop to 38.5C, Lac and MYO are the risk factors of AKI in EHS patients. Multivariate Logistic regression analysis showed that the time required to drop to 38.5C was an independent risk factor for the occurrence of AKI.n Conclusion:AKI is a serious complication of EHS. EHS complicated with AKI, should be identified early and effective intervention measures should be taken.