ABSTRACT
Objective:To analyze the risk factors of renal function recovery in patients with severe acute pancreatitis (SAP) combined with acute kidney injury (AKI).Methods:A retrospective study was conducted in 105 SAP patients with AKI who were admitted to ICU or EICU of the Affiliated Hospital of Qingdao University from January 2013 to October 2019. According to the recovery of renal function at 28 days, the patients were divided into the renal function recovery group and the poor recovery group. Multivariate logistic regression analysis was used to analyze the clinical data of the two groups and to determine the risk factors related to renal function recovery.Results:According to the recovery of renal function, 105 patients were divided into the renal function recovery group ( n=73) and the poor recovery group ( n=32). Compared with the renal function recovery group, patients in the poor recovery group were older, had a higher prevalence of diabetes and coronary heart disease and a higher score on the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ); More patients had abdominal necrosis infection and abdominal hemorrhage. The proportion of patients who applied mechanical ventilation was higher in the poor recovery group. Multivariate logistic regression analysis showed that abdominal necrosis infection ( OR=5.088, 95% CI:1.041-24.871, P=0.044) and mechanical ventilation ( OR=4.615, 95% CI:1.126-18.904, P=0.034) were the independent risk factors of renal function recovery in SAP patients with AKI. Conclusions:Abdominal necrosis infection and mechanical ventilation are the independent risk factors for renal function recovery in patients with SAP and AKI.
ABSTRACT
Objective To compare the intestinal microbiota of septic shock patients and healthy subjects,and study the composition of the intestinal microbiota and its effect on septic shock patients in the intensive care unit (ICU).Methods A total of 15 stool samples were prospectively collected from septic shock patients admitted to the ICU in the First Affiliated Hospital of Zhengzhou University between June 2015 and February 2016,while 15 samples from healthy subjects served as controls.Bacterial DNA was submitted for 16S rDNA gene sequencing.The association between gut microbiota composition and clinical parameters was evaluated.Shannon index was used to assess the bacterial diversity.Results Compared with the healthy subjects,the composition of intestinal microbiota in septic shock patients changed significantly.The abundance of Proteobacteria and Fusobacteria were significantly higher in septic shock patients than in healthy subjects (23.71％ vs 3.53％,P=0.000 6;1.27％ vs 0.12％,P=0.059,respectively).In this study,29 species were identified,and the composition of intestinal microbiota in each patient was highly individualized.There was no significant difference in Shannon index between septic shock patients and healthy subjects (P=0.12).Conclusions The composition of intestinal microbiota in septic shock patients was characterized by high diversity and individualization,but there was the phenomenon of overproduction of single bacteria genus.The relationship between the composition of intestinal microbiota and clinical outcomes requires further exploration by large sample studies.