2檢驗(yàn))及多因素(Logistic回歸)對腎毒性危險(xiǎn)因素進(jìn)行分析。結(jié)果 AKI是羥乙基淀粉注射液嚴(yán)重不良反應(yīng)之一,發(fā)生率為10.08%。單因素分析顯示,體重指數(shù)、低蛋白血癥、肌酐清除率、合并腎毒性藥物、術(shù)中出血量、日劑量和用藥時(shí)間與羥乙基淀粉腎毒性相關(guān);多因素分析顯示,日劑量(≥14 mL/kg)、肌酐清除率(<30mL/min)、用藥時(shí)間(≥5 d)、術(shù)中出血量(>3 000 mL)、合并腎毒性藥物和低蛋白血癥(ALB<30 mL/L)是羥乙基淀粉130/0.4氯化鈉注射液致AKI的獨(dú)立危險(xiǎn)因素。所有患者停藥或經(jīng)相關(guān)治療后腎功能均逐漸恢復(fù)。結(jié)論 日劑量偏大、腎功能不全、長時(shí)間用藥、術(shù)中出血量偏大、合并腎毒性藥物和低蛋白血癥是羥乙基淀粉致AKI的獨(dú)立危險(xiǎn)因素,臨床中重點(diǎn)關(guān)注有獨(dú)立危險(xiǎn)因素的患者,以保證臨床安全用藥。;Objective To investigate the risk factors of acute kidney injury (AKI) which induced by Hydroxyethyl Starch Injection (HES), to provide a reference for clinical safety medication. Methods The 86 non-severe patients with AKI which induced by hydroxyethyl starch injection and 767 patients who were given hydroxyethyl starch injection but not demonstrated AKI from Jan. 2015 to Mar. 2019 in our hospital were respectively analyzed. Single factor (χ2 test) and multiple factors (Logistic regression) were used to select risk factors that related to AKI. Results AKI was one of the serious ADR of hydroxyethyl starch injection, it's incidence was 10.08% in this investigation. According to single factor analysis, factors associated with nephrotoxicity were body mass index, hypoproteinemia, creatinine clearance, combined with nephrotoxic drugs, intraoperative blood loss, daily doseand medication timefor HES;And multivariate analysis identified independent factors with daily dose (≥ 14 mL/kg), creatinine clearance (<30 mL/min), medication time (≥ 5 days), intraoperative blood loss (>3 000 mL), combined with nephrotoxic drugs and hypoproteinemia (ALB<30 mL/L) for hydroxyethyl starch injection. Renal function of all patients was gradually restored after discontinuation of the drug or related treatment. Conclusion Large daily dose, renal insufficiency, long-term medication, intraoperative blood loss, combined with nephrotoxic drugs and hypoproteinemia are independent risk factors for AKI caused by HES. Clinical practice should focus on patients with independent risk factors to ensure clinical safe use of HES."/>

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首頁 > 過刊瀏覽>2019年第42卷第12期 >2019,42(12):2439-2443. DOI:10.7501/j.issn.1674-6376.2019.12.030
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羥乙基淀粉注射液致急性腎損傷的危險(xiǎn)因素分析

Risk factors for acute kidney injury induced by Hydroxyethyl Starch Injection

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