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目的:探讨降钙素原对重症急性胰腺炎发生急性肾损伤的早期预测作用。方法:回顾性分析75例重症急性胰腺炎患者的临床资料。依据患者是否发生急性肾损伤分为AKI组和非AKI组,比较2组患者在入住ICU 2h内的血降钙素原、C反应蛋白、血淀粉酶、肌酐和IL-6水平;对预测重症胰腺炎合并急性肾损伤各个指标进行多元线性回归分析;同时绘制各个指标的ROC曲线,计算并比较各指标的ROC曲线下面积,分析各指标的诊断价值。结果:AKI组25例,非AKI组50例。AKI组的PCT、CRP和IL-6较非AKI组明显升高(P<0.001);多元线性回归分析示PCT、CRP和肌酐与AKI有相关性,且PCT的相关性最大;PCT、CRP、血淀粉酶、肌酐和IL-6的ROC曲线下面积(AUC)分别为0.933、0.898、0.548、0.668和0.739。结论:降钙素原对SAP患者发生AKI具有早期预测价值。
Objective: To investigate the early predictive value of procalcitonin for acute kidney injury in severe acute pancreatitis. Methods: The clinical data of 75 patients with severe acute pancreatitis were retrospectively analyzed. Patients were divided into AKI group and non-AKI group according to whether acute renal injury happened or not. Blood procalcitonin, C-reactive protein, serum amylase, creatinine and IL-6 were compared within 2 hours after ICU admission. Multiple linear regression analysis of each index of acute renal injury with pancreatitis and acute renal injury were performed. At the same time, the ROC curve of each index was plotted, and the area under the ROC curve of each index was calculated and compared, and the diagnostic value of each index was analyzed. Results: There were 25 cases in AKI group and 50 cases in non-AKI group. The levels of PCT, CRP and IL-6 in AKI group were significantly higher than those in non-AKI group (P <0.001). Multiple linear regression analysis showed that PCT, CRP and creatinine were correlated with AKI, The area under the ROC curve (AUC) of serum amylase, creatinine and IL-6 were 0.933, 0.898, 0.548, 0.668 and 0.739, respectively. CONCLUSION: Procalcitonin has early predictive value for the development of AKI in SAP patients.