重症急性胰腺炎患者并发心肌损伤早期危险因素分析  

Analysis of early risk factors of myocardial injury in patients with seve re acute pancreatitis

作　　者：魏肖星 王庆华[1] WEI Xiaoxing;WANG Qinghua(School of Nursing,Binzhou Medical University,Binzhou 256603,Shandong,China;Emergency Intensive Care Unit,Binzhou Medical College Affiliated Hospital,Binzhou 256611,Shandong,China)

机构地区：[1]滨州医学院护理学院,山东滨州256603 [2]滨州医学院附属医院急诊重症监护室,山东滨州256611

出　　处：《当代医药论丛》2023年第23期26-29,共4页

基　　金：山东省自然科学基金面上项目(ZR2022MH117);中国社会福利基金会护爱基金护理创新扶持工程护理课题项目(HLCXKT-20230124)。

摘　　要：目的:分析重症急性胰腺炎(severe acute pancreatitis,SAP)患者并发相关心肌损伤(SAP-associated cardiac injury,SACI)的早期(入院后24小时内)危险因素。方法:回顾性分析某三级甲等医院136例重症急性胰腺炎患者的病例资料,根据有无SACI分为SACI组(34例)和非SACI组(102例)两组。采用单因素分析比较两组患者动脉血气分析和实验室检查指标有无差异;采用多因素Logistic回归分析重症急性胰腺炎患者并发心肌损伤的早期危险因素。结果:单因素分析结果显示,两组纤维蛋白原、肌钙蛋白I、血清淀粉酶、C-反应蛋白、乳酸脱氢酶、肌酸激酶同工酶、pH值、碱剩余、钾离子水平比较差异有统计学意义(P<0.05),其余各项指标均无统计学差异(P>0.05)。多因素Logistic回归分析结果显示,肌钙蛋白I、血清淀粉酶、乳酸脱氢酶、肌酸激酶同工酶是SACI的独立危险因素(P<0.05)。结论:肌钙蛋白I、血清淀粉酶、乳酸脱氢酶、肌酸激酶同工酶是SAP患者并发SACI的早期独立危险因素,对疾病早期诊疗和护理干预具有重要指导作用。Objective:To analyze the risk factors for pancreatic-associated cardiac injury(SACI)in patients with severe acute pancreatitis(SAP)early(within 24 hours after admission to hospital).Methods:The case data of 136 patients with severe acute pancreatitis in a tertiary A hospital were retrospectively analyzed and divided into SACI group(34 cases)and non-SACI group(102 cases)according to whether SACI was present.The difference of arterial blood gas analysis and laboratory examination indexes between the two groups was compared by single factor analysis.Multivariate Logistic regression was used to analyze the early risk factors of myocardial injury in patients with severe acute pancreatitis.Results:The results of single factor analysis showed that there were statistically significant differences in fibrinogen,troponin I,serum amylase,C-reactive protein,lactate dehydrogenase,creatine kinase isoenzyme,pH value,base surplus and potassium ion level between the two groups(P<0.05),while there were no statistically significant differences in other indexes between the two groups(P>0.05).Multiple Logistic regression analysis showed that troponin I,serum amylase,lactate dehydrogenase and creatine kinase isoenzyme were independent risk factors for SACI(P<0.05).Conclusion:Troponin I,serum amylase,lactate dehydrogenase and creatine kinase isoenzyme are early independent risk factors of SACI in SAP patients,which play an important guiding role in early diagnosis and treatment and nursing intervention.

关 键 词：重症急性胰腺炎 心肌损伤 早期危险因素 

分 类 号：R657.51[医药卫生—外科学]