降钙素原对重症急性胰腺炎合并急性肾损伤早期预测作用的研究

Early predicting value of procalcitonin levels in severe acute pancreatitis combined with acute kidney injury

目的:探讨降钙素原对重症急性胰腺炎发生急性肾损伤的早期预测作用。方法:回顾性分析75例重症急性胰腺炎患者的临床资料。依据患者是否发生急性肾损伤分为AKI组和非AKI组,比较2组患者在入住ICU 2h内的血降钙素原、C反应蛋白、血淀粉酶、肌酐和IL-6水平;对预测重症胰腺炎合并急性肾损伤各个指标进行多元线性回归分析;同时绘制各个指标的ROC曲线,计算并比较各指标的ROC曲线下面积,分析各指标的诊断价值。结果:AKI组25例,非AKI组50例。AKI组的PCT、CRP和IL-6较非AKI组明显升高(P<0.001);多元线性回归分析示PCT、CRP和肌酐与AKI有相关性,且PCT的相关性最大;PCT、CRP、血淀粉酶、肌酐和IL-6的ROC曲线下面积(AUC)分别为0.933、0.898、0.548、0.668和0.739。结论:降钙素原对SAP患者发生AKI具有早期预测价值。

Objective：To investigate the early predicting value of procalcitonin levels in severe acute pancreatitis（SAP）combined with acute kidney injury（AKI）.Method：Seventy-five cases of SAP were analyzed and divided into two groups（AKI or non-AKI）according to AKI occurrence.Serum levels of PCT,C reactive protein（CRP）,serum amylase（AMS）,creatinin and interleukin-6（IL-6）were tested on admitting into intensive care unit（ICU）.The correlation between severe acute pancreatitis with AKI and the serum levels of these biomarkers was investigated by multiple linear regression analysis.Receive operating curves（ROC）were generated to determine the predicting value of these biomarkers.Areas under ROC of these biomarkers were compared by U test as well.Result：Serum levels of PCT,CRP and IL-6were significantly（P〈0.001）increased in AKI group（n=25）.The multiple linear regression analysis showed that serum levels of PCT,CRP,and creatinine were significantly correlaed with SAP combined with AKI,and serum levels of PCT was most correlated with AKI.The area under ROC of PCT,CRP,AMS,creatinine and IL-6were 0.933,0.898,0.548,0.668,and 0.739,respectively.Conclusion：Serum PCT is superior to CRP,IL-6,and AMS for predicting the development of AKI in patients with SAP.