中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
25期
13-15
,共3页
胰腺炎,急性坏死性%肾功能不全,急性%增强CT
胰腺炎,急性壞死性%腎功能不全,急性%增彊CT
이선염,급성배사성%신공능불전,급성%증강CT
Pancreatitis,acute necrotizing%Renal insufficiency,acute%Enhanced CT
目的 探讨急性胰腺炎患者增强CT检查和急性肾损伤之间的关系.方法 回顾性分析162例急性胰腺炎患者的临床资料.用RIFLE标准诊断急性肾损伤并分级.根据是否进行增强CT检查分为增强CT组和非增强CT组,检查前已经符合急性肾损伤诊断标准者,纳入非增强CT组分析.结果 增强CT组85例,非增强CT组77例.与非增强CT组比较,增强CT组住院期间血清肌酐水平增加更高[(59±13)μmol/L比(38±11) μmol/L],差异有统计学意义(P＜0.01),急性肾损伤发生率更高[30.6％( 26/85)比15.6％( 12/77)],差异有统计学意义(P＜0.01).增强CT检查使急性肾损伤发生的危险性增加(OR值1.293,95％可信区间1.089 ～ 1.443),经是否合并糖尿病和急性生理学和慢性健康状况Ⅱ评分校正后,增强CT检查仍然是急性肾损伤发生的独立危险因素(OR值1.282,95％可信区间1.185～1.377).结论 增强CT检查是急性胰腺炎患者发生急性肾损伤的一个独立危险因素.如何有选择性地安排增强CT检查,值得进一步研究.
目的 探討急性胰腺炎患者增彊CT檢查和急性腎損傷之間的關繫.方法 迴顧性分析162例急性胰腺炎患者的臨床資料.用RIFLE標準診斷急性腎損傷併分級.根據是否進行增彊CT檢查分為增彊CT組和非增彊CT組,檢查前已經符閤急性腎損傷診斷標準者,納入非增彊CT組分析.結果 增彊CT組85例,非增彊CT組77例.與非增彊CT組比較,增彊CT組住院期間血清肌酐水平增加更高[(59±13)μmol/L比(38±11) μmol/L],差異有統計學意義(P＜0.01),急性腎損傷髮生率更高[30.6％( 26/85)比15.6％( 12/77)],差異有統計學意義(P＜0.01).增彊CT檢查使急性腎損傷髮生的危險性增加(OR值1.293,95％可信區間1.089 ～ 1.443),經是否閤併糖尿病和急性生理學和慢性健康狀況Ⅱ評分校正後,增彊CT檢查仍然是急性腎損傷髮生的獨立危險因素(OR值1.282,95％可信區間1.185～1.377).結論 增彊CT檢查是急性胰腺炎患者髮生急性腎損傷的一箇獨立危險因素.如何有選擇性地安排增彊CT檢查,值得進一步研究.
목적 탐토급성이선염환자증강CT검사화급성신손상지간적관계.방법 회고성분석162례급성이선염환자적림상자료.용RIFLE표준진단급성신손상병분급.근거시부진행증강CT검사분위증강CT조화비증강CT조,검사전이경부합급성신손상진단표준자,납입비증강CT조분석.결과 증강CT조85례,비증강CT조77례.여비증강CT조비교,증강CT조주원기간혈청기항수평증가경고[(59±13)μmol/L비(38±11) μmol/L],차이유통계학의의(P＜0.01),급성신손상발생솔경고[30.6％( 26/85)비15.6％( 12/77)],차이유통계학의의(P＜0.01).증강CT검사사급성신손상발생적위험성증가(OR치1.293,95％가신구간1.089 ～ 1.443),경시부합병당뇨병화급성생이학화만성건강상황Ⅱ평분교정후,증강CT검사잉연시급성신손상발생적독립위험인소(OR치1.282,95％가신구간1.185～1.377).결론 증강CT검사시급성이선염환자발생급성신손상적일개독립위험인소.여하유선택성지안배증강CT검사,치득진일보연구.
Objective To investigate the relationship between enhanced CT examination and acute kidney injury in patients with acute pancreatitis.Methods The clinical data of 162 acute pancreatitis patients were analyzed retrospectively.Acute kidney injury was diagnosed and graded by RIFLE criterion.The patients were divided into two groups according to enhanced CT examination:enhanced CT group and non-enhanced CT group.Results Enhanced CT group had 85 cases,and non-enhanced CT group had 77 cases.The increased creatinine level in enhanced CT group was higher than that in non-enhanced CT group [(59 ± 13 ) μ mol/L vs.(38 ± 11 ) μ mol/L],and there was significant difference between two groups (P ＜0.01 ).The incidence of acute kidney injury in enhanced CT group was higher than that in non-enhanced CT group [30.6％ (26/85) vs.15.6％ (12/77)],and there was significant difference between two groups (P ＜0.01 ).Enhanced CT examination increased the risk of acute kidney injury occurrence (OR =1.293,95％ CI1.089-1.443).After adjusted by diabetes and APACHE Ⅱ score,enhanced CT examination was still an independent risk factor of acute kidney injury (OR =1.282,95％ CI 1.185-1.377 ).Conclusions Enhanced CT examination is a potential risk factor of acute kidney injury in acute pancreatitis patients.The time of enhanced CT examination is worthy of further study.
