急性复发性胰腺炎并发急性肾损伤的影响因素分析  

Analysis of influencing factors of acute kidney injury in acute recurrent pancreatitis

作　　者：王健[1] 郁毅刚[1] 林庆斌 吴燕生[1] WANG Jian;YU Yigang;LIN Qingbin;WU Yansheng(Department of Emergency,the 909th Hospital,Dongnan Hospital of Xiamen University,Zhangzhou,Fujian,363000,China)

机构地区：[1]第九〇九医院(厦门大学附属东南医院)急诊科,福建漳州363000

出　　处：《临床急诊杂志》2023年第12期637-641,共5页Journal of Clinical Emergency

基　　金：军队后勤科研重大项目(No:BLB18J006)。

摘　　要：目的:探讨急性复发性胰腺炎(acute recurrent pancreatitis, ARP)并发急性肾损伤(acute kidney injury, AKI)的影响因素。方法:回顾性分析2019年1月—2022年12月第九〇九医院急诊科收治的76例ARP患者临床资料,根据是否并发AKI分为AKI组(29例)和非AKI组(47例),采用单因素和logistic多因素分析ARP并发AKI的危险因素。结果:AKI组全身炎症反应综合征、腹腔间隔室综合征、辅助通气、中重度AP发生率高于非AKI组,差异有统计学意义(P<0.05);AKI组急性生理与慢性健康评估Ⅱ评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、C-反应蛋白(C-reactive protein, CRP)、降钙素原(procalcitonin, PCT)高于非AKI组,差异有统计学意义(P<0.05);AKI组AP发作间隔时小于非AKI组,差异有统计学意义(P<0.05)。APACHEⅡ评分(OR=12.503,95%CI:3.705~17.431)、AP分级(OR=9.177,95%CI:3.512~18.834)、CRP(OR=9.909,95%CI:1.228~18.440)、PCT(OR=8.876,95%CI:2.661~11.246)是ARP患者发生AKI的独立危险因素(P<0.05)。结论:ARP患者中AKI发生较高,APACHEⅡ评分≥15分、中重症AP、CRP≥42 mmol/L、PCT≥3.35 ng/mL是ARP患者发生AKI的危险因素,早期识别相关危险因素,及早干预,有助于降低AKI发生率。Objective To investigate the influencing factors of acute kidney injury(AKI)in acute recurrent pancreatitis(ARP).Methods The clinical data of 76 ARP patients admitted to the 909th Hospital from January 2019 to December 2022 were retrospectively analyzed.All patients were divided into AKI group(n=29)and non-AKI group(n=47)according to whether they had concurrent AKI.Single factor and logistic multiple factor were used to analyze the risk factors of ARP concurrent AKI.Results The incidence of systemic inflammatory response syndrome,abdominal compartment syndrome,assisted ventilation and moderate to severe AP in AKI group were higher than there in non-AKI group,there were significantly different in two groups(P<0.05).The acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,C-reactive protein(CRP)and procalcitonin(PCT)in AKI group were higher than those in non-AKI group,there were significantly different in two groups(P<0.05).The interval between AP episodes in AKI group was shorter than that in non-AKI group,there were significantly different in two groups(P<0.05).APACHEⅡscore(OR=12.503,95%CI:3.705-17.431),AP score(OR=9.177,95%CI:3.512-18.834),CRP(OR=9.909,95%CI:1.228-18.440)and PCT(OR=8.876,95%CI:2.661-11.246)were independent risk factors for AKI in ARP patients(P<0.05).Conclusion The incidence of AKI is high in ARP patients.APACHEⅡscore≥15,intermediate and severe AP,CRP≥42 mmol/L,and PCT≥3.35 ng/mL are risk factors for AKI in ARP patients.Early identification of related risk factors and early intervention can help reduce the incidence of AKI.

关 键 词：急性复发性胰腺炎 急性肾损伤 并发症 

分 类 号：R657.5[医药卫生—外科学]