影响重症胰腺炎预后的早期危险因素分析

Early risk factors associated with hospital outcomes of severe acute pancreatitis

目的探讨影响重症急性胰腺炎(severe acute pancreatitis,SAP)预后的早期危险因素。方法回顾性分析2000年1月至2010年12月间我院收治的SAP患者90例,按预后分为死亡组(37例)和生存组(53例)。分析比较两组患者临床资料及入院24h内实验室检查指标的差异,并通过Logistic回归分析筛选与预后有关的危险因素。结果死亡组患者年龄、血糖显著高于生存组(P<0.05)。死亡组患者动脉血氧分压、血钙、血清白蛋白显著低于生存组(P<0.05)。高龄(OR=1.589,95%CI:1.195～2.114,P<0.05),动脉血氧分压(OR=0.055,95%CI:0.004～0.700,P<0.05)、血清白蛋白(OR=0.850,95%CI:0.752～0.960,P<0.05)是影响SAP预后的早期因素。结论高龄、低动脉血氧分压、低血清白蛋白可能是影响SAP预后的早期危险因素。

Objective To investigate early risk factors associated with outcomes of severe acute pancre- atitis （SAP） within 24 hours after admission. Methods Ninety SAP patients admitted between Jan.2000 and Dec.2010 were divided into two groups with 37 cases of death and 53 cases of survival. Clinical and laboratory parameters within 24 hours after admission were compared between death group and survival group. Indepen- dent predictors of death were identified by Logistic regression analysis. Results There were significant differ- ences in age, arterial partial pressure of oxygen, blood calcium, blood sugar and serum albumin between death group and survival group （P 〈 0.05）. Logistic regression analysis showed that the elderly （OR = 1.589, 95% CI： 1.195 - 2.114, P 〈 0.05）, low arterial partial pressure of oxygen （OR = 0.055, 95% CI： 0.004 - 0.700, P 〈 0.05） and hypoalbuminemia （OR = 0.850, 95% CI： 0.752 - 0.960, P 〈 0.05） contributed to poor prognosis. Conclu- sion Our study indicates that the elderly, low arterial partial pressure of oxygen and hypoalbuminemia may serve as predictors of outcomes for SAP.