血尿素氮在重症急性胰腺炎中的意义

The value of blood urea nitrogen in patients with severe acute pancreatitis

目的是分析重症急性胰腺炎（SAP）患者的血尿素氮（BUN）在重症监护病房（ICU）住院时间及预后中的意义。方法对2008年1月。2010年6月SAP病例进行分析，并分为住院时间延长组和不延长组；观察人住ICU时血BUN水平对其ICU住院时间及预后的影响。结果病死率单因素分析发现：Ranson评分、血BUN、血糖、腹腔室隔综合征、血钙及氧分压与患者的病死率相关；二维多因素非条件Logistic回归分析（Forward：LR法）发现：Ranson评分和血BUN与病死率关系最密切。ICU住院时间延长组相比不延长组患者，其入院时BUN有显著升高（P=0．006），危险度（OR）为1．030，95％可信区间（CI）1．01～1．098，截断值为30mg／dl，其特异性为89％，敏感性为62％。结论BUN作为单一检验指标，临床检测方便、费用低，适于临床预测SAP患者ICU的住院时间及预后。

Objective To analyze the value of blood BUN in patients with severe acute pancreatitis （SAP） during their ICU stay and prognosis. Methods The SAP cases in ICU between January, 2008 and June, 2010 divided into two groups, normal time group and extended time group, were analyzed in their blood BUN at the time of admission and effect to the prognosis. Results The analysis of mortality revealed that Ranson score, serum BUN, blood glucose, abdominal compartment syndrome, calcium and oxygen partial pressure were related to the mortality; The two-dimensional multi-factor non-conditional Logistic regression analysis （Forward： LR） showed that the Ranson score and blood BUN were closely related with the mortality. The blood BUN level was higher （P =0.006; OR, 1.030; 95% CI, 1.011-1.098） in the extended time group than the normal time group, with the cutoff value of 30 mg/dl, 89% specificity and the 62% sensitivity. Conclusion As a single indicator, although the blood BUN is not as reliable as clinical panereatitis complicated scoring system, it is useful, easy to operate and affordable.