肾功能生化指标对急性肺栓塞患者预后的评估价值  

Evaluation Value of Biochemical Indexes of Renal Function in Prognosis of Patients with Acute Pulmonary Embolism

作　　者：王小雨 WANG Xiao-yu(Department of Respiratory and Critical Care Medicine,People's Hospital of Inner Mongolia Autonomous Region,Hohhot,Inner Mongolia,010017,China)

机构地区：[1]内蒙古自治区人民医院呼吸与危重症医学科,内蒙古呼和浩特010017

出　　处：《中华养生保健》2024年第21期43-47,共5页CHINESE HEALTH CARE

摘　　要：目的探讨肾功能生化指标对急性肺栓塞患者预后的预测价值。方法选择2020年1月—2023年12月内蒙古自治区人民医院收治的231例急性肺栓塞患者为研究对象,对其临床资料实施回顾性分析。将患者的转归分为转归良好和转归不佳两种情况,描述全部患者的预后情况(分组情况),急性肺栓塞患者预后情况的单因素分析以及急性肺栓塞患者预后情况的多因素分析,急性肺栓塞患者预后情况的预测模型以及效能。结果全部纳入研究的231例患者之中,判定为预后不佳的85例(36.80%),判定为预后良好的146例(63.20%)。单因素分析结果显示,预后情况不同患者的肌酐清除率,尿素氮,尿酸,胱抑素C,钠离子,钙离子水平比较,差异具有统计学意义(P<0.05)。Logistic多因素分析得到模型方程为:ln(P/1-P)=23.853-0.106×肌酐清除率+0.372×尿素氮+0.008×尿酸+2.926×胱抑素C-9.909×钙离子。依据多因素分析所筛选出来的变量构建列线图风险模型,C-index为0.792。校准曲线平均绝对误差为0.022。利用各独立影响因素和P值预测概率对急性肺栓塞患者预后情况进行ROC曲线的预测,曲线下面积分别为0.930、0.698、0.714、0.656、0.733、0.966。结论急性肺栓塞患者的短期预后不良与肌酐清除率、尿素氮、尿酸、胱抑素C和钙离子水平息息相关。在急性肺栓塞患者的诊疗过程中对肾功能生化指标监测可能有助于减少不良预后事件。Objective To investigate the prognostic value of biochemical indexes of renal function in patients with acute pulmonary embolism.Methods The data of 231 patients with acute pulmonary embolism treated in the People's Hospital of Inner Mongolia Autonomous Region from January 2020 to December 2023 were retrospectively analyzed.The outcomes of the patients were divided into good outcomes and poor outcomes.Describe the outcomes of all patients(grouping).Univariate analysis of prognosis in patients with acute pulmonary embolism and multivariate analysis of prognosis in patients with acute pulmonary embolism.Predictive model and efficacy of prognosis in patients with acute pulmonary embolism.Results Of the 231 patients included in the study,85(36.80%)were judged to have a poor prognosis and 146(63.20%)were judged to have a good prognosis.The results of univariate analysis showed that there were statistically significant differences in creatinine clearance,urea nitrogen,uric acid,cystatin C,sodium ion and calcium ion levels among patients with different prognosis(P<0.05).logistic multivariate analysis obtained the model equation as follows:ln(P/1-P)=23.853-0.106×creatinine clearance+0.372×urea nitrogen+0.008×uric acid+2.926×cystatin C-9.909×Ca2+.The nomogram risk model was constructed based on the variables screened by multi-factor analysis,and the C-index was 0.792.The average absolute error of calibration curve is 0.022.The ROC curve was used to predict the prognosis of patients with acute pulmonary embolism using independent influencing factors and P-value prediction probability,and the areas under the curve were 0.930,0.698,0.714,0.656,0.733,0.966,respectively.Conclusion Creatinine clearance,urea nitrogen,uric acid,cystatin C and calcium levels are closely related to poor short-term prognosis in patients with acute pulmonary embolism.Monitoring renal function biochemical indexes in the diagnosis and treatment of patients with acute pulmonary embolism may help reduce adverse prognostic events.

关 键 词：肾功能 急性肺栓塞 尿素氮 尿酸 肌酐清除率 

分 类 号：R563.5[医药卫生—呼吸系统]