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目的:探讨狼疮性肾炎(LN)并发急性肾损伤(AKI)的相关危险因素。方法:选择LN 168例,调查其并发AKI与发生感染、高血压病、水肿,以及血浆清蛋白、24h尿蛋白定量、血浆同型半胱氨酸、抗核抗体(ANA)、抗双链DNA(dsDNA)抗体及病理改变情况,分析其相关危险因素。结果:LN 168例并发AKI 47例;AKI组出现水肿、感染、低蛋白血症、高同型半胱氨酸血症,以及肾组织中出现细胞性新月体、毛细血管袢坏死、白金耳、透明血栓的概率均显著高于非AKI组(P<0.05);Logistic多元逐步回归分析结果显示,感染、低蛋白血症、高同型半胱氨酸血症、细胞性新月体形成进入以AKI为因变量的回归方程(P<0.05)。结论:LN并发AKI的危险因素包括感染、低蛋白血症、高同型半胱氨酸血症、细胞性新月体形成等;应针对危险因素采取积极防治措施,以控制病情,延缓肾脏病进展。
Objective: To investigate the related risk factors of lupus nephritis (LN) complicated with acute kidney injury (AKI). Methods: A total of 168 LN patients were selected to investigate the relationship between AKI and infection, hypertension, edema, plasma albumin, 24 h urinary protein, plasma homocysteine, anti-nuclear antibody (ANA) dsDNA) antibody and pathological changes, analysis of its associated risk factors. Results: There were 168 cases of LN complicated with AKI in 47 cases. AKI group had edema, infection, hypoalbuminemia, hyperhomocysteinemia, and cellular crescent, capillary necrosis, (P <0.05). Logistic multiple stepwise regression analysis showed that infection, hypoalbuminemia, hyperhomocysteinemia, and cellular crescent formation were associated with AKI For the dependent variable regression equation (P <0.05). Conclusions: The risk factors of LN complicated with AKI include infection, hypoalbuminemia, hyperhomocysteinemia and cellular crescent formation. Active prevention and control measures should be taken for risk factors to control the disease and delay the progression of kidney disease .