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中文摘要: 目的 探讨上海市青浦地区急性肾损伤预警系统的建立与应用效果。方法 收集青埔区1 429例成人(≥18岁)急性心肌梗死患者作为此次研究对象，其中测试病例为1 033例，验证病例为396例。 根据患者是否存在急性肾损伤将其分组为对照组(非急性肾损伤)与观察组(急性肾损伤)，并对两组相关因素进行比较和分析，同时对有意义因素行多因素logistic回归分析，并因此建立急性肾损伤电子预警系统，然后予以验证。结果 1 429例患者中，观察组患者死亡率为10.48%，明显高于对照组的0.49%（χ2=92.953，P=0.000）。1 033例测试病例中，观察组死亡率为10.14%，明显高于对照组0.56%(χ2=61.165，P=0.000)。396例验证病例中，观察组死亡率为11.29%，明显高于对照组0.29%(χ2=31.913，P=0.000)。观察组患者总平均住院时间为(8.26±1.24) d，明显长于对照组(5.98±0.72) d，t=37.346，P=0.000。经单因素分析发现，年龄、糖尿病病史和高血压病史等为急性心肌梗死患者发生急性肾损伤的影响因素（P＜0.05）。多因素logistic回归分析发现，高血压病史、心源性休克和发病至入院时间超过6 h等为急性心肌梗死患者发生急性肾损伤的高危因素（P＜0.05）。经验证发现电子预警系统, 接收者工作特征曲线下面积(AUC)为0.704。结论 根据心肌梗死患者发生急性肾损伤高危因素创建电子预警系统对临床早期识别和诊断急性肾损伤具有较高价值。
Abstract:objective To explore the establishment and application of early warning system for acute kidney injury in Qingpu area.Methods 1 429 adults (≥18 years old) with acute myocardial infarction in Qingpu District were enrolled as the study subjects, including 1033 test cases and 396 confirmed cases. According to whether patients had acute kidney injury, they were divided into control group (non-acute kidney injury) and observation group (acute kidney injury), and the related factors were compared and analyzed. Logistic regression analysis was performed on the meaningful factors. Therefore, an electronic warning system for acute kidney injury was established and then verified.Results Among the 1429 patients, the mortality rate of the observation group was 10.48% , which was significantly higher than that of the control group (0.49% (χ2=92.953, P=0.000). Among the 1 033 test cases, the observed group mortality rate 10.14% , significantly higher than the control group 0.56% (χ2=61.165, P=0.000). Among the 396 confirmed cases, the observed group mortality was 11.29% , obviously It was 0.29%, higher than the control group,
(χ2=31.913, P=0.000). The average hospital stay in the observation group was (8.26±1.24) d, which was significantly longer than that of the control group (5.98±0.72) d, t=37.346, P=0.000. Univariate analysis showed that age, history of diabetes, and history of hypertension were the influencing factors of acute kidney injury in patients with acute myocardial infarction（P＜0.05）. Multiple factors found that history of hypertension, cardiogenic shock, and onset to hospital for more than 6 h were risk factors for acute kidney injury in patients with acute myocardial infarction（P＜0.05）. It has been verified that the electronic warning system AUC is 0.704.Conclusion The establishment of an electronic early warning system based on the high risk factors of acute kidney injury in patients with myocardial infarction has a high value for early identification and diagnosis of acute kidney injury.
文章编号：3201901031 中图分类号：R692 文献标志码：
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