摘要
目的:研究危重型新型冠状病毒肺炎(COVID-19)患者的病情特征以及其发生急性肾损伤(AKI)的特点。方法:对武汉大学中南医院重症医学科(ICU)自2020年1月8日至2020年2月24日收治的62例确诊危重型COVID-19患者的临床资料进行分析。记录该部分患者的人口统计学数据、起病情况、既往合并慢性疾病、实验室检查结果、CT影像检查结果以及相关治疗,并分析以上患者病情特征和AKI发病情况。以2012年KDIGO指南诊断AKI。结果:62例患者平均年龄62.9岁,男性39例,占62.9%;10例(16.1%)为院内感染,52例(83.9%)为院外感染。62例患者中18例出现AKI,AKI发病率为29.0%,其中9例接受了连续性肾脏替代治疗(CRRT)。所有COVID-19患者均接受呼吸支持治疗,其中48.3%患者接受有创机械通气治疗,AKI患者的呼吸支持力度高于非AKI患者。危重型COVID-19患者病死14例,总体病死率22.6%,合并AKI患者病死率为44%。结论:危重型COVID-19患者AKI发病风险高,器官支持力度高,预后不佳,应引起重视。
Objective:To investigate clinical features and the morbidity of patients with severe coronavirus disease 2019(COVID-19)complicated with acute kidney injury(AKI).Methods:We enrolled 62 patients with severe COVID-19 admitted to Intensive Care Unit(ICU)from January 8,2020 to February 24,2020 in Zhongnan Hospital of Wuhan University.The demographic data,symptoms,physical signs,comorbidities,laboratory results and related treatment of these patients were recorded.AKI was defined according to the diagnostic criteria of KDIGO guideline in 2012.Results:The mean age of 62 patients was 62.9 years old,and 39(62.9%)were male.10 patients(16.1%)were presumed to be infected in hospital,and 52(83.9%)were community infection cases.18(29.0%)patients occurred AKI during their ICU stay and 9 of them received continuous renal replacement therapy(CRRT).All patients with severe COVID-19 received respiratory support,48.3%of them received invasive mechanical ventilation,and the respiratory supporting level of AKI patients was higher than that of non-AKI patients.Up to Feb 24,14 severe COVID-19 patients died during their hospital stay and the overall mortality was 22.6%.Mortality of patients with AKI was 44.4%.Conclusion:The risk of AKI in patients with severe COVID-19 is high and the prognosis is poor,although organ supporting technologies were adopted.
作者
徐申
胡洪涛
胡玉刚
水华
XU Shen;HU Hongtao;HU Yugang;SHUI Hua(Dept.of Nephrology,General Hospital of the Yangze River Shipping,Wuhan 430015,Hubei,China;Dept.of Nephrology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Dept.of Critical Care Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Dept.of Ultrasound,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第4期537-541,共5页
Medical Journal of Wuhan University
作者简介
徐申,女,1993-,医学硕士生,主要从事急慢性肾损伤研究,E-mail:snk_xs2016@163.com;通讯作者:水华,女,1969-,医学博士,教授,硕士生导师,主要从事急慢性肾损伤研究,E-mail:shuihua@whu.edu.com
