急性胰腺炎并腹腔感染患者影响因素分析及其预测模型构建  

Analysis of Influencing Factors and Prediction Model for Patients with Acute Pancreatitis Complicated by Abdominal Infection

作　　者：葛春阳 蔡兆辉[1] 左爽 李玉 李海山[1] GE Chunyang;CAI Zhaohui;ZUO Shuang(The Second People's Hospital of Hefei,Anhui Hefei 230011,China)

机构地区：[1]安徽省合肥市第二人民医院急诊科,安徽合肥230011

出　　处：《河北医学》2024年第8期1326-1330,共5页Hebei Medicine

基　　金：2022年安徽省重点研究与开发计划项目,(编号:2022e07020058)。

摘　　要：目的:分析急性胰腺炎(AP)并腹腔感染患者的影响因素,并构建预测模型,为AP并腹腔感染的早期防治提供参考。方法:搜集2021年1月至2023年12月我院收治的103例AP患者为对象,依据患者有无腹腔感染分为感染组及无感染组。明确AP并腹腔感染的独立影响因素,同时构建预测模型,ROC曲线分析预测模型的对腹腔感染的预测价值。结果:103例AP患者,腹腔感染占比32.04%(33/103)。AP并腹腔感染患者致病菌以革兰阴性菌为主,主要致病菌大肠埃希菌、肺炎克雷伯对常用抗菌药物耐药率较高。Logistic回归结果示,年龄、住院时间、入院时APACHEⅡ评分、CRP、PCT、NK细胞总量是AP并腹腔感染的独立影响因素(P<0.05)。ROC曲线分析结果示模型ROC曲线的AUC为0.843(95%CI为0.792~0.896)、敏感性为61.36%、特异性为92.06%、约登指数为0.534,Homser-Lemeshow检验P值为0.267,一致率为96.12%,结论:AP并腹腔感染风险较高,AP并腹腔感染与患者年龄、住院时间、入院时APACHEⅡ评分、CRP、PCT、NK细胞总量有关,Logistic预测模型可有效预测AP并发腹腔感染的风险。Objective:To analyze the influencing factors of patients with acute pancreatitis(AP)com-plicated by abdominal infection and to construct a prediction model,providing a reference for early prevention and treatment of AP with abdominal infection.Methods:Data from 103 AP patients admitted to Hefei Second People's Hospital between January 2021 and December 2023 were collected.Patients were divided into infec-ted and non-infected groups based on the presence of abdominal infection.Independent influencing factors for AP with abdominal infection were identified,and a prediction model was constructed.The predictive value of the model for abdominal infection was assessed using ROC curve analysis.Results:Among the 103 AP pa-tients,32.04%(33/103)had abdominal infections.The predominant pathogens were Gram-negative bacteri-a,with Escherichia coli and Klebsiella pneumoniae showing high resistance to common antibiotics.Logistic re-gression identified age,length of hospital stay,APACHE II score at admission,CRP,PCT,and total NK cell count as independent influencing factors for AP with abdominal infection(P<0.05).ROC curve analysis showed the model's AUC was 0.843(95%CI0.792~0.896),with a sensitivity of 61.36%,specificity of 92.06%,Youden index of 0.534,Homser-Lemeshow test P value of 0.267,and concordance rate of 96.12%.Conclusion:The risk of abdominal infection in AP patients is relatively high and is associated with age,length of hospital stay,APACHE II score at admission,CRP,PCT,and total NK cell count.The logis-tic prediction model effectively predicts the risk of abdominal infection in AP patients.

关 键 词：急性胰腺炎 腹腔感染 预测模型 

分 类 号：R576[医药卫生—消化系统]