目的：回顾性评估3年内在本院新生儿重症监护室（NICU）住院治疗的新生儿急性肾损伤（AKI）的发病率、危险因素和结局情况。方法：选择2015年1月至2017年12月期间入住本院NICU的新生儿作为研究对象。收集所有新生儿的人口统计数据（性别、胎龄、出生体重）、基线和最大SCr、肾脏病转诊、住院时间和死亡率的信息。评估AKI的潜在危险因素，包括胎龄<32周的婴儿临床危险指数-Ⅱ（CRIB Ⅱ）评分、1 min和5 min Apgar评分、围产期抑郁症、脑室内出血、动脉导管未闭、脓毒症、坏死性小肠结肠炎和暴露于肾毒性药物。结果：在3年研究期间共纳入了120例NICU新生儿，其中76例出现AKI，发生率为63.3%。与非AKI的新生儿相比，AKI患儿的胎龄、出生体重、1 min和5 min Apgar评分显著降低（P<0.05），并且住院期间脓毒症和暴露于肾毒性药物的发生率显著增加（P<0.05）。风险分析中，仅胎龄（OR=4.6，95%CI：3.0~9.4）和暴露于肾毒性药物（OR=10.8，95%CI：2.6~46.2）与AKI发生显著相关（P<0.05）。对于胎龄<32周的婴儿，只有CRIBⅡ评分（OR=1.9；95%CI：1.4~2.5）与AKI风险增加相关（P<0.05）。AKI新生儿的总死亡率为26.3%（20/76），非AKI的患者为6.8%（3/44）（P<0.001）。AKI患儿的中位（IQR）住院时间为27 d（14~45 d），显著高于非AKI的患者的13.5 d（8~31 d）（P<0.05）。在调整胎龄后，AKI与死亡率（OR=5.4，95%CI：2.3~14.8，P<0.001）和住院时间（OR=3.9，95%CI：1.2~8.4，P<0.01）显著相关。结论：超过一半NICU新生儿发生AKI，并且AKI与患儿的死亡率和住院时间增加有关。为了改善AKI新生儿预后，识别高危新生儿并密切监测肾功能至关重要。

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