血清肌酐胱抑素C血尿素氮对重症急性胰腺炎并发急性肾损伤的预测效能  

Predictive efficacy of Scr,CysC,and BUN in severe acute pancreatitis complicated with acute kidney injury

作　　者：陈鲲鹏 张丽丽 Chen Kunpeng;Zhang Lili(Laboratory of Tongxu County Traditional Chinese Medicine Hospital,Kaifeng,Henan 475000,China)

机构地区：[1]通许县中医院检验科,河南开封475000

出　　处：《实用医技杂志》2023年第8期538-542,共5页Journal of Practical Medical Techniques

基　　金：河南省医学科技攻关项目(SBGJ202102027)。

摘　　要：目的分析血清肌酐(SCr)、血清胱抑素C(CysC)、血尿素氮(BNU)对重症急性胰腺炎(SAP)并发急性肾损伤(AKI)的预测效能。方法本文为回顾性研究,纳入河南省通许县中医院2021年1月至2023年4月收治的100例SAP患者,根据是否合并AKI将SAP患者分为AKI组(40例)和非AKI组(60例),收集、对比2组患者的一般资料、临床资料,经单因素分析、Logistic多因素回归分析归纳导致SAP并发AKI的危险因素;经Spearman相关性系数检验肾功能指标与SAP并发AKI的相关性,通过绘制受试者工作特征(ROC)曲线并观察曲线下面积(AUC)分析各肾功能指标对SAP并发AKI的预测效能。结果2组患者的年龄、休克、多器官功能衰竭、血液指标、血清炎症因子、肾功能指标差异均有统计学意义(P<0.05);Logistic多因素回归分析结果显示,年龄≥60岁,合并休克、合并多器官功能衰竭,白细胞计数(WBC)≥10×10^(9)/L,中性粒细胞及淋巴细胞比值(NLR)≥10%,C反应蛋白(CRP)≥100 g/L,降钙素原(PCT)≥20μg/L,SCr>100μmol/L,CysC>1 mg/L,BUN>8μmol/L为导致SAP并发AKI的危险因素。经Spearman相关性检验,Scr、CysC、BUN指标与AKI发生率呈正相关;ROC曲线显示,Scr、CysC、BUN异常升高可导致SAP并发AKI(AUC均>0.85)。结论血液指标、炎症指标及肾功能指标异常为导致高龄、合并休克及多器官功能衰竭的SAP并发AKI的危险因素,Scr、CysC、BUN水平与AKI发生率正相关,对SAP并发AKI有较高预测效能。Objective To analyze the predictive performance of SCr,CysC,and BNU on SAP complicated with AKI.Methods This article is a retrospective study,with cases including 100 SAP patients admitted to Tongxu County Hospital of Traditional Chinese Medicine from January 2021 to April 2023.SAP patients were divided into AKI group(40 cases)and non AKI group(60 cases)based on whether AKI was combined.General and clinical data of the two groups of patients were collected and compared,and the risk factors for SAP complicated with AKI were summarized through statistical univariate analysis and logistic multivariate regression analysis;The correlation between renal function indicators and SAP complicated AKI was tested by Spearman correlation coefficient,and the predictive efficacy of various renal function indicators on SAP complicated AKI was analyzed by plotting ROC and observing AUC.Results The results of the statistical univariate analysis showed that there were certain differences in age,shock,multiple organ failure,blood indicators,serum inflammatory factors,and renal function indicators between the two groups of patients(P<0.05);The results of logistic multiple factor regression analysis showed that age≥60 years old,combined with shock and multiple organ failure,WBC≥10×10^(9)/L,NLR≥10%,CRP≥100 g/L,PCT≥20μg/L,SCr>100μmol/L,CysC>1 mg/L,BUN>8μmol/L were risk factors leading to SAPcomplicated by AKI.According to Spearman correlation coefficient test,Scr,CysC,BUN indicators are positively correlated with the incidence of AKI;The ROC curve shows that abnormal increases in Scr,CysC,and BUN can lead to SAP complicating AKI(AUC>0.85).Conclusion Abnormal blood indicators,inflammatory indicators,and renal function indicators are risk factors for SAP complicating with AKI in elderly patients,combined with concomitant shock,and multiple organ failure.The levels of Scr,CysC,and BUN are positively correlated with the incidence of AKI,and have a high predictive effect for SAP complicating with AKI.

关 键 词：胰腺炎 肌酐 胱抑素C 尿素氮 急性肾损伤 预测 

分 类 号：R576[医药卫生—消化系统] R692.5[医药卫生—内科学] R446.11[医药卫生—临床医学]