ICU急性腎損傷病人進(jìn)展至3期的早期預(yù)測模型構(gòu)建

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[關(guān)鍵詞]急性腎損傷；重癥監(jiān)護(hù)病房；疾病惡化；預(yù)測；列線圖[中圖分類號(hào)］R692.5 [文獻(xiàn)標(biāo)志碼]A [文章編號(hào)] 2096-5532（2025）03-0449-05doi：10.11712/jms.2096-5532.2025.61.101 [開放科學(xué)（資源服務(wù)）標(biāo)識(shí)碼（OSID）][網(wǎng)絡(luò)出版] https：//link.cnki.net/urlid/37.1517.R.20250730.1031.004; 2025-07-3014：46：54

Establishmentofanearlypredictivemodelforprogresiontostage3inpatientswithacutekidneyinjuryintheintensivecarenit CHEN Beixiang，HUANG Zhiwen，LIULele（Departmentof IntensiveCare Medicine，F(xiàn)ifth Afiliated Hospitalof Zhengzhou University，Zhengzhou 45000o，China）

[Abstract]ObjectiveTo investigate the influencing factors for progressionto stage 3acute kidney injury（AKI in patients admitedtotheintensivecareunit（ICU），andtoestablishanomogrampredictionmodel.MethodsAtotalof169AKIpatients who were admitted to the ICU in our hospital fromJanuary 2022 to January 2024 were enroled，andat a ratio of 3：1 ，theywere randomly dividedintoatrainingset with128patientsandavalidationset with41 patients.Accordingtothe presenceorbsenceof progression to stage 3 AKI，they were divided into stage 1-2 AKI group and stage 3 AKI group. The influencing factors for progresion to stage3AKI were analyzed，andanomogram prediction model was established.ResultsThere were significant differences between the stage 1-2 AKI group and the stage 3 AKI group in comorbidity with type 2 diabetes，preoperative renal function staging，white bloodcell（WBC）count，historyofprotonpump inhibitor（PPIuse，andurinaryproteincharacterization （20 （χ2=6.171-15.197，P<0.05） . The multivariate logistic regression showed that preoperative renal function staging，WBC count， history of PPI use，and urinary protein characterization were risk factors for progresson to stage 3 AKI （ P<0.05） .Thenomogram prediction model for progresson to stage 3 AKI had an area under the ROC curve of . The calibrationcurveandtheclinical decisioncurve showed that thenomogram modelhad goodpredictive performance.ConclusionPreo perativerenalfunctionstaging，WBCcount，historyofIuse，andurinaryproteincharacterizationareriskfactorsforprogresion to stage3AKI.Thenomogram predictionmodelforprogressiontostage3AKIestablishedbasedontheaboveriskfactors hasgood predictive performance.

[Key words]acute kidney injury；intensive care unit；disease progression；forecasting； nomograms

急性腎損傷（AKD是由多種病因引起的短時(shí)間內(nèi)腎功能快速減退的臨床綜合征，特征為腎小球?yàn)V過率顯著下降，導(dǎo)致體內(nèi)氮質(zhì)產(chǎn)物潴留，同時(shí)伴隨水電解質(zhì)和酸堿平衡的紊亂[1]。（剩余5841字）