摘要
目的探究横纹肌溶解综合征(rhabdomyolysis,RM)患者血清肌红蛋白、肌酸激酶(creatine kinase,CK)以及二者比值对急性肾功能衰竭(acute kidney injury,AKI)的预测作用。方法回顾性分析在江苏省人民医院及南京市浦口医院住院接受治疗的120例RM患者的临床资料,比较AKI患者和非AKI患者的血清CK、肌红蛋白浓度及两者比值,CK、肌红蛋白值和肌红蛋白/CK比值从最低到最高分为四分位数,统计AKI发生率、病死率以及分布,采用Spearman分析肌红蛋白、CK与AKI发生的相关性;分别采用单因素Logistic回归分析和多因素Logistic回归分析探究预测AKI的风险因子。结果47例(39.16%)RM患者并发AKI,其中42例患者进行了血液透析治疗,经透析的患者发生2例死亡(病死率4.76%),其余患者全部存活。AKI患者和非AKI患者的血清肌红蛋白浓度和CK活性显著高于非AKI患者(P<0.05);经Spearman分析,血清肌红蛋白浓度、血清CK活性与AKI的发生的相关系数分别为:0.51(P=0.003)、0.22(P=0.019)。多因素Logistic回归分析则表明血清肌红蛋白为AKI的显著预测因子,肌红蛋白/CK比值的第三、第四分位数均为AKI发生的显著预测因子(P<0.05)。结论血清肌红蛋白以及肌红蛋白/CK的比值是预测AKI的显著风险因子,建议在入院时即进行检测。
Objective To analyze the prediction value of myoglobin,creatine kinase(CK)and the myoglobin/CK ratio in acute renal failure(ARF)in patients with rhabdomyolysis syndrome(RM).Methods The clinical data of 120 RM patients who were treated in People′s Hospital of Jiangsu Province and Pukou Hospital of Nanjing City were retrospective analyzed.Serum CK and myoglobin values and the myoglobin/CK ratio were compared between AKI patients and non-AKI patients,and classified into quartiles from the lowest to highest values.The incidence rate of AKI,mortality rate and the corresponding AKI distribution were calculated,and Spearman analysis was used to analyze the relevance between myoglobin,CK,and AKI.Univariate and multivariate Logistic regression analysis were used to explore the risk factors for predicting AKI.Results A total of 47 cases(39.16%)of RM patients were complicated with AKI,of whom 42 patients were treated with hemodialysis.Of them,2 patients died(death rate of 4.76%)and the remaining patients survived.Serum myoglobin concentration and CK activity in AKI patients were significantly higher than those in non-AKI patients(P<0.05);Spearman analysis showed that the correlation coefficients of serum myoglobin concentration,serum CK activity and AKI were 0.51(P=0.003)and 0.22(P=0.019),respectively.Multivariate Logistic regression analysis showed that the serum myoglobin was a significant predictor of AKI,and the third and fourth quantiles of the myoglobin/CK ratio were all significant predictors of AKI(P<0.05).Conclusion Serum myoglobin and the myoglobin/CK ratio are significant risk factors for predicting AKI.Therefore,the test is recommended to be performed at admission.
作者
高田
王淦楠
王巍
张劲松
GAO Tian;WANG Gan-nan;WANG Wei;ZHANG Jin-song(Department of Intensive Care Unit, Pukou Hospital of Nanjing City, Jiangsu Province, Nanjing 210000, China;Department of Emergency Medicine, People′s Hospital of Jiangsu Province/the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)
出处
《河北医科大学学报》
CAS
2021年第4期386-389,400,共5页
Journal of Hebei Medical University
基金
江苏省南京市医学科技发展项目(YKK15223)。
