肾血管阻力指数联合降钙素原对急性胰腺炎患者发生急性肾损伤预测价值

目的了解肾血管阻力指数联合降钙素原(PCT)对急性胰腺炎患者发生急性肾损伤预测价值。方法收集2016年1月至2019年1月我院收治的72例急性胰腺炎患者作为观察组,根据入院7天内是否发生急性肾损伤,将患者分为合并急性肾损伤组和未合并急性肾损伤组,搜集患者入院时资料,包括PCT和肾血管阻力指数,观察PCT和肾血管阻力指数与急性胰腺炎患者发生急性肾损伤的关系,并分析急性肾损伤的影响因素。结果合并急性肾损伤组PCT和肾血管阻力指数均高于未合并急性肾损伤组(P<0.05)。急性肾损伤3级患者PCT和肾血管阻力指数均高于急性肾损伤1级、2级患者(P<0.05),急性肾损伤2级患者PCT和肾血管阻力指数均高于急性肾损伤1级患者(P<0.05)。合并急性肾损伤组APACHEⅡ评分、血肌酐、血乳酸、血淀粉酶、24h尿蛋白高于未合并急性肾损伤组(P<0.05),合并急性肾损伤组尿量低于未合并急性肾损伤组(P<0.05)。多因素分析结果显示,PCT、肾血管阻力指数、APACHEⅡ评分及24h尿蛋白是急性胰腺炎患者发生急性肾损伤的独立危险因素(P<0.05)。PCT、肾血管阻力指数、APACHEⅡ评分预测急性胰腺炎患者发生急性肾损伤的曲线下面积分别为0.78、0.75、0.72(P<0.05)。PCT联合肾血管阻力指数预测急性胰腺炎患者发生急性肾损伤具有较高灵敏度和特异度。结论急性胰腺炎患者PCT和肾血管阻力指数与急性肾损伤严重程度呈正相关,PCT和肾血管阻力指数增加是急性胰腺炎发生急性肾损伤的危险因素,PCT联合肾血管阻力指数预测急性胰腺炎患者发生急性肾损伤的价值较高。

Renal vascular resistance index combined with procalcitonin in predicting acute renal injury in patients with acute pancreatitis

Objective To understand the predictive value of renal vascular resistance index combined with procalcitonin(PCT)for acute renal injury in patients with acute pancreatitis.Methods Seventy-two patients with acute pancreatitis admitted in our hospital from January 2016 to January 2019 were collected as observation objects.According to whether acute kidney injury occurred within 7 days after admission,patients were divided into patients with acute kidney injury group and those without acute kidney injury(non-acute kidney injury group).Data were collected on admission,including PCT and renal vascular resistance index,and the relationship between PCT and renal vascular resistance index and acute renal injury in patients with acute pancreatitis were observed,and the influencing factors of acute renal injury were analyzed.Results The PCT and renal vascular resistance index in acute kidney injury group were higher than those in non-acute kidney injury group(P<0.05).PCT and renal vascular resistance index of patients with acute renal injury grades of 3 were higher than those of patients with acute renal injury of grades 1 and 2(P<0.05).PCT and renal vascular resistance index of patients with acute renal injury of grades 2 were higher than those of acute renal injury of grades 1(P<0.05).The APACHEⅡscore,serum creatinine,blood lactate,blood amylase,and 24 h urine protein in the acute kidney injury group were higher than those in non-acute kidney injury group(P<0.05),and urine volume was lower than that in non-acute kidney injury group(P<0.05).Multivariate analysis showed that PCT,renal vascular resistance index,APACHEⅡscore and 24 h urinary protein were independent risk factors for acute renal injury in patients with acute pancreatitis(P<0.05).The areas under the curve of ROC in PCT,renal vascular resistance index,and APACHEⅡscore to predict acute renal injury in patients with acute pancreatitis were 0.78,0.75,and 0.72,respectively(P<0.05).PCT combined with renal vascular resistance index had higher sensitivity and specificity in predicting acute renal injury in patients with acute pancreatitis.Conclusion PCT and renal vascular resistance index are positively correlated with the severity of acute renal injury in patients with acute pancreatitis.Increased PCT and renal vascular resistance index are risk factors for acute renal injury in acute pancreatitis.PCT combined with renal vascular resistance index has a higher value in predicting acute renal injury in patients with acute pancreatitis.