关键词: 急性上消化道出血, 急性肾损伤, 并发症, 危险因素

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the risk factors of secondary acute kidney injury （AKI） and its risk factors of progression in patients with acute upper gastrointestinal bleeding （AUGIB）.
Ｍｅｔｈｏｄｏｌｏｇｙ：The clinical data of 233 patients with AUGIB admitted to Dongnan Hospital Affiliated to Xiamen University from January 2021 to June 2023 were retrospectively analyzed.They were divided into AKI group （n=67） and non-AKI group （n=166） according to whether acute kidney injury （AKI） occurred after admission.67 patients with AKI were divided into progressive group （n=21） and non-progressive group （n=46） according to the progression of AKI.The risk factors of secondary acute kidney injury and progression of upper gastrointestinal hemorrhage were analyzed by univariate and multivariate analysis.
Ｒｅｓｕｌｔｓ：Among the 233 AUGIB patients，157 had digestive tract ulcers，42 had esophageal varices，18 had acute gastric mucosal injury，10 had esophageal and cardia lacerations，and 6 had foreign bodies.Among them，67 patients had AKI （28.76%）.Of 67 patients with AKI，21 cases of AKI progress，progress rate of 31.34%.Unifactor analysis showed that in AUGIB，the incidence of AKI was higher in patients with coronary heart disease，cirrhosis，platelet count <50×109／L，hemoglobin count <60 g／L，blood albumin <35 g／L，and upper gastrointestinal bleeding grade high risk （P<0.05）.Multivariate analysis found that，AKI was associated with coronary heart disease （OR=2.706，95%CI 1.127～6.494），platelet count <50×109／L （OR=3.570，95%CI 1.249～10.203），and upper gastrointestinal bleeding grade with higher risk（OR=3.078，95%CI 1.145～8.227）.Univariate analysis found that among 67 patients with AUGIB secondary AKI，The incidence of AKI progression was higher in patients with male，diabetes mellitus，hepatitis B，cirrhosis，previous history of upper gastrointestinal bleeding，platelet count <50×109／L，hemoglobin count <60 g／L，serum albumin <35 g／L，and upper gastrointestinal bleeding grade high risk （P<0.05）.Multivariate analysis found that，Cirrhosis （OR=7.975，95%CI 1.400～45.441），platelet count <50×109／L （OR=19.612，95%CI 2.640～145.703），upper gastrointestinal bleeding grade high risk （OR=6.814，95%CI 1.183～27.985）.
Ｃｏｎｃｌｕｓｉｏｎ：Patients with AUGIB should be alert to the occurrence of AKI. Coronary heart disease，platelet count <50×109／L，and higher risk of upper gastrointestinal bleeding grade are independent risk factors for AKI development，while liver cirrhosis，platelet count <50×109／L，and higher risk of upper gastrointestinal bleeding grade are independent risk factors for AKI progression.

Key words: acute upper gastrointestinal hemorrhage, acute kidney injury, complications, risk factor