横纹肌溶解症致急性肾损伤危险因素的Logistic回归分析

杨倩; 朱长清; 叶晨安

doi:10.13201/j.issn.1009-5918.2020.03.012

横纹肌溶解症致急性肾损伤危险因素的Logistic回归分析

- 上海交通大学医学院附属仁济医院急诊科(上海, 200127)

详细信息

通讯作者: 叶晨安,E-mail:2420311880@qq.com

中图分类号: R685.5

收稿日期: 2019-12-29

Logistic regression analysis of risk factors for acute renal injury caused by rhabdomyolysis

- Department of Emergency Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China

More Information

Corresponding author: YE Chenan, E-mail: 2420311880@qq.com

Received Date: 29 December 2019

摘要

摘要: 目的:探讨横纹肌溶解症(RM)的临床特点,分析RM合并急性肾损伤(AKI)的危险因素。方法:回顾性分析我院2013-07-2018-12期间的73例RM患者的临床资料,包括病因、性别、年龄、临床表现、实验室指标、住院天数等,分析RM致AKI的危险因素。结果:①RM患者男性多于女性(男49例,女24例),平均年龄(36.29±15.78)岁,单病因共64例,其中运动47例,进食小龙虾4例,感染3例,药物3例,其他7例(包括饮酒2例,摔伤2例,甲状腺功能减退1例,癫痫1例,糖尿病肌病1例);双重病因5例,三重病因4例。②研究发现年龄、肌红蛋白、白蛋白在RM合并AKI组与RM非AKI组差异有统计学意义(P<0.05),而住院天数、CK、ALT、AST、血钾、血pH值、尿pH值、性别、肌力、饮酒史在两组间差异无统计学意义(P>0.05),提示年龄、肌红蛋白和白蛋白可能是RM合并AKI的危险因素。③多因素分析提示低蛋白血症(OR=0.769,95%CI:0.627~0.943,P=0.012)、高肌红蛋白(OR=1.659,95%CI:1.006~2.734,P=0.047)是预测横纹肌溶解导致AKI的预测因子,白蛋白的AUC为0.815(0.654~0.976),肌红蛋白的AUC为0.846(0.739~0.963)。结论:低蛋白血症、高肌红蛋白是RM并发AKI的独立危险因素。为临床早期发现RM合并AKI提供一定的预测作用,以期进一步及时治疗,改善患者预后。
- 横纹肌溶解 /
- 急性肾损伤 /
- 肌红蛋白 /
- 白蛋白 /
- Logistic回归分析
Abstract: Objective:To investigate the clinical features of Rhabdomyolysis(RM) and analyze the risk factors of RM combined with Acute renal injury(AKI). Method:The clinical data of 73 RM patients in our hospital from July 2013 to December 2008 were analyzed retrospectively, including etiology, gender, age, clinical manifestations, laboratory indicators,length of hospital stay, etc., to analyze the risk factors of RM-induced AKI. Result:1. There were more males than females in RM patients(male 49 cases, female 24 cases), average age was 36.29±15.78 years old.64 cases had single factor, which contains 47 cases of exercise, 4 cases of eating crayfish, 3 cases of infection, 3 cases ofmedicine and other 7 cases(including 2 cases of drinking, 2 cases of trauma, 1 case of hypothyroidism, 1 case of epilepsy, 1 case diabetic myopathy). Meanwhile, there were dual factors in 5 cases and three factors in 4 cases. 2. The study found that age, myoglobin, albumin between AKI group and non-AKI group have statistically difference(P<0.05), and hospitalization days, CK, ALT, AST, blood potassium, blood PH value, urine PH value, gender, muscle strength and drinking history have not obvious difference between the two groups(P>0.05). The result prompted age, myoglobin and albumin may be a risk factor for RM induced AKI. 3. Multivariate analysis suggested that hypoproteinemia(OR=0.769, 95%CI:0.627-0.943, P=0.012) and hypermyoglobin(OR=1.659, 95%CI:1.006-2.734, P=0.047) were predictors of rhabdomyolysis leading to AKI, the AUC of albumin was 0.815(0.654-0.976), and the AUC of myoglobin was 0.846(0.730-0.963).Conclusion:Hypoproteinemia and hypermyoglobin are independent risk factors for RM induced AKI. The conclusion provide a certain predictive role for early clinical detection of RM induced AKI and find a view to further timely treatment and improved prognosis of patients.
- rhabdomyolysis /
- acute renal injury /
- myoglobin /
- albumin /
- Logistic regression analysis

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