监测NLR、PLR、CAR、白蛋白、血钙及血糖指标水平对急性胰腺炎患者急性肾损伤的预测价值分析  

Analysis of the predictive value of monitoring NLR,PLR,CAR,albumin,serum calcium and blood glucose levels in acute kidney injury in patients with acute pancreatitis

作　　者：崔秋子 姚红曼 艾迎春[1] Cui Qiuzi;Yao Hongman;Ai Yingchun(Department of Gastroenterology,Hongda Hospital,Jiamusi University,Jiamusi 154000,China)

机构地区：[1]佳木斯大学宏大医院消化内科,黑龙江省154000

出　　处：《中华消化病与影像杂志（电子版）》2024年第3期244-248,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的分析监测中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、白蛋白(ALB)、C反应蛋白(CRP)/ALB比值(CAR)、血钙及血糖指标水平对急性胰腺炎(AP)患者急性肾损伤(AKI)的预测价值。方法纳入佳木斯大学宏大医院2020年10月~2023年10月收治的120例AP患者,按照其AKI发生情况,将患者分别纳入AKI组、非AKI组。比较2组患者入院时NLR、PLR、ALB、CRP、血钙、血糖指标,运用Logistic多因素回归分析和受试者工作特征曲线(ROC),计算上述指标预测AP患者发生AKI的价值。结果120例AP患者中,31例发生AKI,AKI发生率为25.84%。Logistic多因素回归分析示,中重度AP、NLR≥6、PLR≥150、ALB<35 g/L、CAR≥1.5、血钙<2.0 mmol/L、血糖≥9.0 mmol/L均为影响AP患者发生AKI的独立危险因素(P<0.05)。AP病情严重度联合NLR、PLR、ALB、CAR、血钙、血糖预测AP患者发生AKI的AUC为0.822,灵敏度83.87%、特异性84.27%(P<0.05)。结论AP患者AKI发生率较高且AKI的发生与患者病情、炎症状态、营养状态、血钙及血糖水平均存在密切关联,联合监测上述因素能够为AKI的预测提供可靠参考。Objective To analyze the predictive value of monitoring neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),albumin(ALB),C-reactive protein(CRP)/ALB ratio(CAR),serum calcium and blood glucose levels in acute kidney injury(AKI)in patients with acute pancreatitis(AP).Methods A total of 120 AP patients admitted to Jiamusi University Hongda Hospital from October 2020 to October 2023 were included.According to the occurrence of AKI,the patients were divided into AKI group and non-AKI group.The NLR,PLR,ALB,CRP,serum calcium and blood glucose levels of the two groups were compared on admission.Logistic multivariate regression analysis and receiver operating characteristic curve(ROC)were used to calculate the predictive value of the above indicators for AKI in AP patients.Results Among the 120 AP patients,31 patients had AKI,with an incidence of AKI of 25.84%.Logistic multivariate regression analysis showed that moderate to severe AP,NLR≥6,PLR≥150,ALB<35 g/L,CAR≥1.5,serum calcium<2.0 mmol/L,and blood glucose≥9.0 mmol/L were independent risk factors for AKI in AP patients(P<0.05).The AUC of AP severity combined with NLR,PLR,ALB,CAR,serum calcium,and blood glucose in predicting AKI in AP patients was 0.822,with sensitivity and specificity of 83.87%and 84.27%(P<0.05).Conclusion The incidence of AKI in AP patients is high,and the occurrence of AKI is closely related to the patient's condition,inflammatory status,nutritional status,blood calcium and blood glucose levels.Joint monitoring of these factors can provide reliable reference for the prediction of AKI.

关 键 词：急性胰腺炎 急性肾损伤 中性粒细胞/淋巴细胞比值 白蛋白 血钙 血糖 

分 类 号：R576[医药卫生—消化系统] R692[医药卫生—内科学]