摘要
目的探讨65岁及以上老年人急性肾衰竭(ARF)的特点、病因、预后及其相关因素。方法收集我院1995年1月至2005年12月11年间诊断的老年ARF共150例,统计分析老年人ARF的特点、病因、预后及其相关影响因素。结果老年人ARF占同期全部ARF患者总数33%,老年人医院内获得性ARF(HA-ARF)的发生率为54%,明显高于社区获得性ARF(CA-ARF,P<0.05)。老年ARF的发生有逐年增高的趋势。老年ARF以肾前性ARF为主,多因素综合病因分析显示:与感染(56%)相关为首位病因,其次与低血容量(30.7%)、肿瘤(26%)、心功能衰竭(25.3%)、肾毒性药物(22%)、手术(14%)、肾脏疾病(14.7%)及肾后性疾病(8.7%)相关。单因素病因分析显示与低血容量相关为首位病因(21.6%)。老年ARF多由多种病因共同导致,其死亡率高达53.3%,HA-ARF死亡率是CA-ARF死亡率的1.87倍。结论老年人易患ARF。HA-ARF的增多是主要原因。感染、低血容量、肿瘤、心功能衰竭、肾毒性药物及手术是老年人ARF的常见原因。加强原发病的整体治疗,尽早发现并治疗ARF,有助于改善预后。
Objective To investigate the characteristics, pathogenetic factors and prognosis of hospitalized elderly patients with acute renal failure （ARF）. Methods The data of hospitalized elderly patients with ARF in our hospital from January 1995 to December 2005 were retrospectively analyzed. The etiology, characteristics and prognosis and the relative factors of the patients aged 65 years or older who presented ARF were investigated. Results One hundred and fifty hospitalized elderly patients were diagnosed to have ARF, accounting for 33% of total hospitalized patients with ARF. Among these patients, the incidence of hospital acquired-ARF（HA-ARF,54%） was higher than that of community acquired-ARF（CA-ARF, 46 % ）（P〈0.05）. There was an tendency of increasing ARF in the elderly patients yearly. Many cases were pre-renal failure. Multifactorial analysis of etiologies showed that infections （about 56%） were the main causes of ARF in hospitalized elderly patients, the other causes were low blood volume （ 30.7 % ）, tumor（ 26 % ）, congestive heart failure （ 25.3 % ）, nephrotoxic drugs （ 22 % ）, surgery （ 14 % ）, underlying renal diseases（ 14.7% ）and urinary tract obstruction（8.7% ）. In single factor analysis, low blood volume（21.6% ） was the main cause. ARF elderly patients was mainly caused by multiple etiologies. The overall fatality rate of elderly patients with ARF was 53.3% and the fatality rate of HA-ARF was 1.87-fold greater than that of CA-ARF. Conclusion The elderly patients are susceptive to get ARF in hospital. Infections, low blood volume, tumor, congestive heart failure, drugs with renal toxicity and surgical operations are the main causes of HA-ARF. Early diagnosis and treatment of ARF are beneficial for improving the prognosis.
出处
《中华老年多器官疾病杂志》
2007年第4期253-256,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
老年人
肾衰竭
急性
预后
elderly
renal failure, acute
prognosis
作者简介
赵佳慧，女，1973年5月生，辽宁沈阳人，在读博士研究生，主治医师。Tel：13641328097通讯作者：程庆砾，Tel：010-66939864
