摘要
目的探讨急性胰腺炎(AP)患者并发肾脏损害的临床特点及AP严重程度的MRI评价与肾损伤的相关性。方法对115例AP病例资料进行回顾性分析,了解肾损害的发生率及特点。根据MRI表现,AP分为水肿型和坏死型。按照MR严重程度指数(MRSI)评分,AP分为轻度(0～3分)、中度(4～6分)、重度(7～10分)。分析肾功能指标(BUN、Cr及尿常规检查),并与MRSI比较。结果 115例AP中,轻度32例,中度78例,重度5例;水肿型95例,坏死型20例。33例合并肾损害,占28.7%,以蛋白尿阳性[30.3%(10/33)]为主。坏死型AP较水肿型AP肾损害发生率高(分别为55%和23%,二者比较P=0.004)。在MRSI上,轻、中、重度AP血BUN和(或)Cr升高及尿常规异常的发生率分别为3.1%和6.3%、11.3%和17.0%、20.0%和21.0%,随MRSI评分的增加,肾功能异常有增多的趋势,但差异无统计学意义(P=0.29;P=0.70)。结论坏死型AP较水肿型AP更易导致肾损害,肾损害以蛋白尿常见;MRI能够在一定程度上预测AP所伴发的肾脏功能受损,但MRSI尚不能作为预测AP肾功能受损的指标。
Objective To study the clinical features of kidney injury in acute pancreatitis（AP）and the correlation between the severity of AP on MR imaging and kidney injury.Methods 115 AP patients were retrospectively analyzed,all of whom had performed abdominal MR imaging.AP was categorized into edematous and necrotizing according to their MR findings,and graded into mild（0-3 scores）,moderate（4-6 scores）and severe（7-10 scores）according to the MR severity index（MRSI）.The results of kidney function test（BUN,Cr and routine urinalysis）were noted and compared with the severity of AP on MRSI.Results In the 115 AP patients,83%（95/115）patients had edematous AP and 17%（20/115）patients had necrotic AP on MR imaging.According to MRSI,the mild,moderate and severe AP were 28%（32/115）,68%（78/115）and 4%（5/115）respectively.28.7%（33/115）patients with AP had kidney injury,which had at least one index abnormality in kidney function test,proteinuria（30.3%）was the common type.The prevalence of kidney injury in necrotic AP was 55.0%,which was higher than 23% in edematous AP（P=0.004）.The BUN and（or） Cr elevated and abnormal routine urinalysis were,respectively,3.1% and 6.3% patients in mild,11.3% and 17.0% patients in moderate,and 20.0% and 21.0% patients in severe AP.The frequency of kidney function abnormality in patients with AP tended to increase following the MRSI scores rise.However,no significant difference for the frequencies can be seen among mild,moderate and severe AP（respectively,P=0.29,P=0.70）.Conclusions Kidney injury can be seen in necrotic AP more than in edematous AP,proteinuria is the most common type of kidney injury.MR imaging may help to predict kidney function abnormality in AP.However,MRSI could not be an index for predicting the abnormality of kidney function in AP.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第5期82-85,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
胰腺炎
磁共振成像
疾病严重程度指数
肾功能损害
Pancreatitis
Magnetic resonance imaging
Severity of illness index
Renal insufficiency
