胃肠病学
胃腸病學
위장병학
Chinese Journal of Gastroenterology
2015年
10期
592-596
,共5页
急性胰腺炎%急性肾损伤%D-二聚体%降钙素原%钙
急性胰腺炎%急性腎損傷%D-二聚體%降鈣素原%鈣
급성이선염%급성신손상%D-이취체%강개소원%개
Acute Pancreatitis%Acute Kidney Injury%D-Dimer%Procalcitonin%Calcium
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。
揹景：急性腎損傷（AKI）是急性胰腺炎（AP）早期嚴重的併髮癥之一，對其進行早期識彆和榦預具有重要的臨床意義。目的：探討 AP 患者入院後48 h 內的臨床指標對 AKI 的早期預測價值。方法：迴顧性分析2014年1月-2014年12月武漢大學人民醫院收治的205例 AP 患者，按照 KDIGO 標準分為 AKI 組和非 AKI 組，比較兩組間人口統計學特徵和慢性疾病患病情況，以及入院後48 h 內 Ranson 評分、BISAP 評分和生化指標，評估各指標對 AKI 的早期預測價值，分析各指標與 AKI 的關聯彊度。結果：與非 AKI 組相比，AKI 組 Ranson 評分、BISAP 評分、D-二聚體、PCT、血糖和三酰甘油水平顯著升高（P <0.05），血鈣水平顯著降低（P <0.05）。D-二聚體、PCT、血鈣早期預測 AKI 的準確性較高，AUC 分彆為0.881、0.803和0.782。Logistic 迴歸分析顯示，D-二聚體、PCT 和血鈣與 AKI 關聯彊度較高（OR 均>7）（P <0.05）。結論：D-二聚體、PCT 和血鈣是早期預測 AP 患者髮生 AKI 的有效、經濟的臨床指標。
배경：급성신손상（AKI）시급성이선염（AP）조기엄중적병발증지일，대기진행조기식별화간예구유중요적림상의의。목적：탐토 AP 환자입원후48 h 내적림상지표대 AKI 적조기예측개치。방법：회고성분석2014년1월-2014년12월무한대학인민의원수치적205례 AP 환자，안조 KDIGO 표준분위 AKI 조화비 AKI 조，비교량조간인구통계학특정화만성질병환병정황，이급입원후48 h 내 Ranson 평분、BISAP 평분화생화지표，평고각지표대 AKI 적조기예측개치，분석각지표여 AKI 적관련강도。결과：여비 AKI 조상비，AKI 조 Ranson 평분、BISAP 평분、D-이취체、PCT、혈당화삼선감유수평현저승고（P <0.05），혈개수평현저강저（P <0.05）。D-이취체、PCT、혈개조기예측 AKI 적준학성교고，AUC 분별위0.881、0.803화0.782。Logistic 회귀분석현시，D-이취체、PCT 화혈개여 AKI 관련강도교고（OR 균>7）（P <0.05）。결론：D-이취체、PCT 화혈개시조기예측 AP 환자발생 AKI 적유효、경제적림상지표。
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.
