重症急性胰腺炎肾损伤危险因素分析

Analysis of risk factors for acute kidney injury in severe acute pancreatitis

目的：探讨重症急性胰腺炎（severe acute pancreatitis，SAP）发生急性肾损伤的相关危险因素。方法回顾性分析收治的245例SAP患者临床资料，根据是否发生肾损伤将患者分为急性肾损伤（acute kidney injury，AKI）组及非急性肾损伤（non-acute kidney injury，NAKI）组，AKI组43例，NAKI组202例，比较组间相关指标的差异。结果 SAP相关AKI的发生率为17．6％（43／245）。AKI组患者平均BMI[（26．8±7．4）vs（22．3±5．6）]、高脂血症发生率（58．1％vs 31．2％）较高，组间比较差异有统计学意义（P＜0．05）。相关指标的多元回归分析发现，BMI（OR 1．17，95％CI 1．06～1．30，P＜0．05），高脂血症（OR 2．96，95％ CI 1．49～5．92，P＜0．05）是SAP发生AKI的独立危险因素。结论肥胖、高脂血症是SAP发生AKI的的独立危险因素，可作为预测SAP患者发生AKI的预测指标。

Objective To investigate the risk factors of acute kidney injury in severe acute pancreatitis（SAP）.Methods The clinical data of 245 patients with SAP were retrospectively collected.Allthe enrolled patients were divided into the acute kidney injury（AKI）group（n =43）and nonacute kidneyinjury（NAKI）group（n =202）.The differences of related indexes were compared between groups.Results The incidence of AKI is 17.6%（43 /245）.Comparison of related indexes manifested that mean BMI[（26.8 ±7.4）vs（22.3 ±5.6）]and incidence of hyperlipemia（58.1% vs 31.2%）of the AKI group wassignificantly higher（P 〈0.05）.The results of logistic regression manifested that BMI（OR 1.17,95% CI1.06 ~1.30,P 〈0.05）and hyperlipemia（OR 2.96,95% CI 1.49 ～5.92,P 〈0.05）were two independent risk factors for AKI during the course of SAP.Conclusion Obesity and hyperlipemia are two independent risk factors for AKI in patients with SAP,which can be used as predictors of AKI in SAP.