新型冠状病毒感染合并肾功能损伤患者临床特征及影响因素分析
Clinical characteristics and influencing factors of renal function impairment in COVID-19 patients
谢娜 1卢志武 2孜比尔妮萨·亚库普 3钱倩倩 4陆蕾 5朱慧敏 5秦旭阳 5舒占钧6
作者信息
- 1. 832008,石河子大学第一附属医院中医内二科
- 2. 830049 乌鲁木齐,新疆医科大学第八临床医学院血净中心
- 3. 830049 乌鲁木齐,新疆医科大学第八临床医学院肾病科
- 4. 830049 乌鲁木齐,新疆医科大学第八临床医学院中西医结合科
- 5. 830054 乌鲁木齐,新疆医科大学第四临床医学院
- 6. 830099 乌鲁木齐,新疆医科大学第四附属医院中医临床研究基地
- 折叠
摘要
目的 探讨新型冠状病毒感染(corona virus disease 2019,COVID-19)合并肾功能损伤患者的临床特征及影响因素.方法 采用多中心回顾性临床研究,选取2020年7—9月和2022年10—12月收治于新疆医科大学第八附属医院及第四附属医院(新型冠状病毒感染救治定点医院)住院的成人COVID-19患者为研究对象.收集患者的一般及临床资料,总结其肾功能损伤的临床特征及影响因素.结果 498例确诊的COVID-19成人患者在住院期间肾功能损伤的发生率为23.29％(116/498),其中男性占比61.21％(71/116);3.82％(19/498)的患者进展为急性肾损伤.5.42％(27/498)的患者血肌酐升高,22.89％(114/498)的患者血尿素氮升高,17.74％(82/498)的患者蛋白尿阳性,21.17％(105/498)的患者尿潜血阳性.男性、既往患有高血压、血小板计数<125.0×109/L、丙氨酸氨基转移酶>50.0 U/L、D-二聚体>1.0μg/L、白介素-6>7.0 pg/mL、血沉>20 mm/h均是成人COVID-19患者发生肾功能损伤的独立危险因素.结论 男性、合并高血压及血小板、丙氨酸氨基转移酶、D-二聚体、白介素、血沉水平均是成人COVID-19患者发生肾功能损伤的影响因素.临床上尽早识别危险人群,定期进行肾功能、肾脏超声和尿常规检查,是保护肾脏、延缓肾脏疾病进展的重要方式及手段.
Abstract
Objective To investigate the clinical features and influence factors of patients with corona virus disease 2019 ( COVID-19 ) complicated with renal function injury. Methods Using a multi center retrospective clinical study, we selected adult COVID-19 patients admitted to the Eighth Affiliated Hospital and the Fourth Affiliated Hospital of Xinjiang Medical University ( designated hospital for COVID-19 treatment ) from July to September 2020 and October to December 2022 as the research objects. The general and clinical data of patients were collected and analyzed. Results In total, 498 hospitalized patients with COVID-19 were collected. During hospitalization, 23.29％ of patients had renal impairment, and 61.21％ were male. Three point eight two percent of the patients progressed to acute kidney injury. Five point forty two percent of patients had elevated Scr index and 22.89％ of patients had elevated BUN index. Proteinuria was present in 17.74％ of patients and hematuria was present in 21.17％ of the patients. COVID-19 patients with renal function impairment do not prolong the overall hospital stays. Male, preexisting hypertension, platelet count < 125.0×109/L, alanine aminotransferase > 50.0 U/L, D-dimer > 1.0 μg/L, interleukin-6 > 7.0 pg/mL, and ESR > 20 mm/h were all independent risk factors for renal function impairment in adult patients with COVID-19. Conclusions Male, concomitant hypertension, platelets, alanine aminotransferase, D-dimer, interleukin, and average blood sediment are the influencing factors for renal function damage in adult COVID-19 patients. Early identification of high-risk individuals in clinical practice and regular renal function, renal ultrasound, and urine routine examinations are important ways and means to protect the kidneys and delay the progression of kidney diseases.
关键词
COVID-19/肾功能异常/临床特征/影响因素Key words
COVID-19/renal function impairment/clinical characteristics/influencing factor引用本文复制引用
基金项目
新疆维吾尔自治区自然科学基金(2021D01A130)
出版年
2024
NETL
NSTL
万方数据