中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
20期
1-2
,共2页
张敏%刘思纯%陈源汉%马博%李初俊%朱颖钰%梁馨苓
張敏%劉思純%陳源漢%馬博%李初俊%硃穎鈺%樑馨苓
장민%류사순%진원한%마박%리초준%주영옥%량형령
重症急性胰腺炎%增强CT%APACHEⅡ评分%急性肾损伤
重癥急性胰腺炎%增彊CT%APACHEⅡ評分%急性腎損傷
중증급성이선염%증강CT%APACHEⅡ평분%급성신손상
Sever acute pancreatitis%Contrast-enhanced computed tomography%APACHE Ⅱ scores%Acute kidney disease
目的 研究增强CT检查和重症急性胰腺炎(SAP)患者发生急性肾损伤(AKI)的关系.方法 定义急性生理功能和慢性健康状况评分系统APACHEⅡ评分≥8分为SAP,用RIFLE标准诊断AKI.结果 收集到84例SAP患者的临床资料,进行增强CT者54例.增强CT组和未进行增强CT组AKI发生率分别为59.3％和40.0％ (P=0.090).在APACHEⅡ评分≥15分的亚组中,进行增强CT(25例)和非增强CT(19例)的患者发生AKI的比例分别为68.4％和24.0％ (P=0.003).经APACHEⅡ评分校正后,增强CT检查是AKI发生的独立危险因素(OR值1.247,95％可信区间1.195 ～1.387).在APACHEⅡ评分≥15分的患者中,进行增强CT检查使发生AKI风险显著增加(OR值4.293,95％可信区间3.101 ～5.087).结论 增强CT可能是SAP患者发生急性肾损伤的一个危险因素,尤其是病情严重的个体.
目的 研究增彊CT檢查和重癥急性胰腺炎(SAP)患者髮生急性腎損傷(AKI)的關繫.方法 定義急性生理功能和慢性健康狀況評分繫統APACHEⅡ評分≥8分為SAP,用RIFLE標準診斷AKI.結果 收集到84例SAP患者的臨床資料,進行增彊CT者54例.增彊CT組和未進行增彊CT組AKI髮生率分彆為59.3％和40.0％ (P=0.090).在APACHEⅡ評分≥15分的亞組中,進行增彊CT(25例)和非增彊CT(19例)的患者髮生AKI的比例分彆為68.4％和24.0％ (P=0.003).經APACHEⅡ評分校正後,增彊CT檢查是AKI髮生的獨立危險因素(OR值1.247,95％可信區間1.195 ～1.387).在APACHEⅡ評分≥15分的患者中,進行增彊CT檢查使髮生AKI風險顯著增加(OR值4.293,95％可信區間3.101 ～5.087).結論 增彊CT可能是SAP患者髮生急性腎損傷的一箇危險因素,尤其是病情嚴重的箇體.
목적 연구증강CT검사화중증급성이선염(SAP)환자발생급성신손상(AKI)적관계.방법 정의급성생리공능화만성건강상황평분계통APACHEⅡ평분≥8분위SAP,용RIFLE표준진단AKI.결과 수집도84례SAP환자적림상자료,진행증강CT자54례.증강CT조화미진행증강CT조AKI발생솔분별위59.3％화40.0％ (P=0.090).재APACHEⅡ평분≥15분적아조중,진행증강CT(25례)화비증강CT(19례)적환자발생AKI적비례분별위68.4％화24.0％ (P=0.003).경APACHEⅡ평분교정후,증강CT검사시AKI발생적독립위험인소(OR치1.247,95％가신구간1.195 ～1.387).재APACHEⅡ평분≥15분적환자중,진행증강CT검사사발생AKI풍험현저증가(OR치4.293,95％가신구간3.101 ～5.087).결론 증강CT가능시SAP환자발생급성신손상적일개위험인소,우기시병정엄중적개체.
Objective To study the relationship between contrast-inhanced CT and acute kidney injury (AKI) in patients with sever acute pancreatitis (SAP).Methods The SAP was defined as the APACHE Ⅱ score ＞ or =8 and the AKI was diagnozed by RIFLE criterion.Results Clinical data from 84 SAP patient were studied.The AKI occurrence ratio in the contrast inhanced CT group and in the non-contrast inhanced CT was 59.3％ versus 40.0％ (P =0.090).In the APACHE Ⅱ score ＞ or =15 subgroup analysis,the patients with contrast inhanced CT had a higher AKI occurrence ratio than those without contrast inhanced CT (68.4％ versus 24.0％,P =0.003).After adjusted by the APACHE Ⅱ score,contrast inhanced CT was a risk factor for AKI occurrence (Odds ratio 1.247,95％ confidence interval 1.195-1.387).Inthe patients with APACHE Ⅱ score ＞ or =15,contrast-inhanced CT increased the risk for AKI (Odds ratio 4.293,95％ confidence interval 3.101-5.087).Conclusions Contrast-inhanced CT is a potential risk factor for AKI in SAP patients,especially in those with worse condition.
