重症急性胰腺炎患者并发急性肾损伤的影响因素 分析.

Objective To investigate the influencing factors of acute kidney injury (AKI) in patients with severe acute pancreatitis (SAP). Methods A retrospective study was conducted to collect the clinical data of 66 patients with SAP, and they were divided into AKI group and non-AKI group according to whether they had AKI, and the risk factors of AKI in SAP patients were analyzed by logistic regression and receiver operating characteristic (ROC) curve, respectively. Results The overall age, acute physiology and chronic health status assessment (APACHEII.) scores of patients with SAP and AKI were higher than those without comorbidity, but diabetes mellitus was more common in patients without comorbidity (P<0.05). The results of stepwise regression analysis showed that increased APACHEII. score, SIRI, platelet/lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and serum calcium were independent risk factors for AKI in SAP patients (P<0.05).< THE RESULTS OF ROC CURVE SHOWED THAT, IN ADDITION TO SERUM CREATININE, APACHE II. SCORE, SIRI INDEX AND SERUM CALCIUM LEVEL HAD CERTAIN DIAGNOSTIC VALUE FOR AKI IN PATIENTS WITH SAP, AMONG WHICH THE AUC OF APACHEII SCORE WAS 0.880 (95%CI 0.787~0.974, CUT-OFF VALUE 11.50 points), the AUC of SIRI index was 0.662 (95%CI 0.521~0.804, cut-off value 10.89), and the AUC of serum calcium level was 0.754(95%CI 0.627~0.881, cut-off value 2.07 mmol/L), P < 0.05; When the above three indexes were combined with serum creatinine, the diagnostic efficacy of AKI in patients with SAP could be further improved, and the AUC of serum creatinine + serum calcium was the largest, reaching 0.969 (95%CI 0.929~1.000, P<0.05). SIRI index and serum calcium level have diagnostic value for AKI in patients with SAP, and the combination of serum creatinine can improve the diagnostic efficacy of AKI, providing a new means for clinical identification of AKI in patients with SAP. [ABSTRACT FROM AUTHOR]