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| DOI： |
| 中文关键词: 中性粒细胞/白细胞比值 中性粒细胞/淋巴细胞比值 系统免疫炎症指数 重症急性胰腺炎 急性肾损伤 |
| 英文关键词:Neutrophil/leukocyte ratio Neutrophil/lymphocyte ratio Systemic immune inflammatory index Severe acute pancreatitis Acute kidney injury |
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| 中文摘要: |
| 目的：探讨中性粒细胞与白蛋白比值(NAR)、中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞和血小板乘积与淋巴细胞比值(SII)对重症急性胰腺炎(SAP)并发症急性肾损伤(AKI)的预测价值。方法：回顾性分析厦门大学附属东南医院2022年1月至2023年6月收治147例SAP患者临床资料,根据是否发生AKI分为AKI组(n=44)和非AKI组(n=103)。对比两组患者一般资料、检验指标和并发症指标,采用Logistic分析SAP患者并发AKI危险因素,绘制受试工作者曲线(ROC)分析NAR、NLR、SII对SAP患者并发AKI的预测价值,对比不同AKI损伤程度患者NAR、NLR、SII。结果：AKI组APACHE Ⅱ评分、SIRS 评分、CTSI评分、胱抑素C、NAR、NLR、SII高于非AKI组(P<0.05),血钙低于非AKI组(P<0.05)；多因素分析发现SIRS 评分(95%CI：1.407～6.946,OR：3.566)、胱抑素C(95%CI：2.136～11.538,OR：3.967)、NAR(95%CI：1.956～13.728,OR：5.955)、NLR(95%CI：2.527～15.261,OR：7.000)、SII(95%CI：2.746～19.350,OR：9.178)、脓毒症(95%CI：1.743～8.636,OR：3.690)是SAP并发AKI的独立危险因素；ROC曲线分析NAR、NLR、SII对SAP患者并发AKI具有预测价值,曲线下面积AUC分别为0.738、0.857、0.856(P<0.05),联合NAR、NLR和SII预测SAP患者并发AKI曲线下面积为0.912(P<0.05)；44例AKI患者中1级患者10例、2级患者24例、3级患者10例,3级患者NAR、NLR、SII高于2级患者和1级患者(P<0.05),2级患者NAR、NLR、SII高于1级患者(P<0.05)。结论：SAP并发AKI患者中NAR、NLR和SII升高,是AKI发生的危险因素,AKI损伤程度越重,NAR、NLR和SII越高,联合NAR、NLR和SII对于AKI具有预测价值。 |
| 英文摘要: |
| Objective：To investigate the predictive value of neutrophil to albumin ratio (NAR), neutrophil to lymphocyte ratio (NLR), neutrophil and platelet product to lymphocyte ratio (SII) in acute kidney injury (AKI) of severe acute pancreatitis (SAP).Methods：The clinical data of 147 SAP patients admitted to Dongnan Hospital of Xiamen University from January 2022 to June 2023 were retrospectively analyzed.They were divided into AKI group (n=44) and non-AKI group (n=103) according to whether AKI occurred.The general data, test indexes and complication indexes of the two groups were compared. The risk factors of AKI in SAP patients were analyzed by Logistic analysis. The predictive value of NAR, NLR and SII for AKI in SAP patients were analyzed by ROC. The NAR, NLR and SII of patients with different AKI injury were compared.Results：APACHE Ⅱ score, SIRS score, CTSI score, cystatin C, NAR, NLR and SII in AKI group were higher than those in non-AKI group (P<0.05), and blood calcium was lower than that in non-AKI group (P<0.05).Multivariate analysis showed that SIRS score (95%CI: 1.407-6.946, OR: 3.566), cystatin C (95%CI: 2.136-11.538, OR: 3.967), NAR (95%CI: 1.956-13.728, OR: 5.955), NLR (95%CI: 2.527-15.261, OR: 7.000), SII (95%CI: 2.746-19.350, OR: 9.178) and sepsis (95%CI: 1.743-8.636, OR: 3.690) were independent risk factors for SAP complicated with AKI.ROC curve analysis of NAR, NLR and SII had predictive value for AKI in SAP patients, and the area under the curve AUC was 0.738, 0.857 and 0.856, respectively (P<0.05). The area under the curve combined with NAR, NLR and SII predicted AKI in SAP patients was 0.912 (P<0.05).Among the 44 patients with AKI, 10 were Grade 1 patients, 24 were grade 2 patients, and 10 were Grade 3 patients. NAR, NLR, and SII were higher in Grade 3 patients than in grade 2 patients and Grade 1 patients (P<0.05), and NAR, NLR, and SII were higher in grade 2 patients than in grade 1 patients (P<0.05).Conclusions：NAR, NLR and SII are increased in SAP patients complicated with AKI, which are risk factors for AKI. The more severe the AKI, the higher the NAR, NLR and SII. The combination of NAR, NLR and SII has predictive value for AKI. |
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