摘要
背景:急性肾损伤(AKI)是急性胰腺炎(AP)早期严重的并发症之一,对其进行早期识别和干预具有重要的临床意义。目的:探讨AP患者入院后48 h内的临床指标对AKI的早期预测价值。方法:回顾性分析2014年1月-2014年12月武汉大学人民医院收治的205例AP患者,按照KDIGO标准分为AKI组和非AKI组,比较两组间人口统计学特征和慢性疾病患病情况,以及入院后48 h内Ranson评分、BISAP评分和生化指标,评估各指标对AKI的早期预测价值,分析各指标与AKI的关联强度。结果:与非AKI组相比,AKI组Ranson评分、BISAP评分、D-二聚体、PCT、血糖和三酰甘油水平显著升高(P<0.05)血钙水平显著降低(P<0.05)。D-二聚体、PCT、血钙早期预测AKI的准确性较高,AUC分别为0.881、0.803和0.782。Logistic回归分析显示,D-二聚体、PCT和血钙与AKI关联强度较高(OR均>7)(P<0.05)。结论:D-二聚体、PCT和血钙是早期预测AP患者发生AKI的有效、经济的临床指标。
Background：Acute kidney injury（AKI）is one of the early serious complications of acute pancreatitis（AP）. Early identification and intervention have important clinical significance. Aims：To investigate the early predictive value of clinical indicators found within 48 hours after admission for AKI in patients with AP. Methods：A retrospective analysis of 205 AP patients from January 2014 to December 2014 at Renmin Hospital of Wuhan University was performed. AP patients were divided into AKI group and non-AKI group according to the KDIGO standard,the demographic characteristics,history of chronic diseases and indicators defined within 48 hours after admission such as Ranson score,BISAP score and biochemical indices were compared. The early predictive value of clinical indicators for AKI was evaluted,and strength of association between clinical indicators and AKI was assessed. Results：Compared with non-AKI group,Ranson score, BISAP score,D-dimer,PCT,blood glucose,triacylglycerol were significantly increased in AKI group（P〈 0. 05）,and calcium was significantly decreased（P〈 0. 05）. The accuracies of D-dimer,PCT,calcium were high for early prediction of AKI,and the AUC were 0. 881,0. 803 and 0. 782,respectively. Logistic regression analysis showed that D-dimer, PCT,calcium had marked correlation with AKI（OR all〉 7）（P〈 0. 05）. Conclusions：D-dimer,PCT and calcium are effective and economical clinical indicators for the early prediction of AKI in patients with AP.
出处
《胃肠病学》
2015年第10期592-596,共5页
Chinese Journal of Gastroenterology
