腹部外伤患者SAPS-Ⅱ评分和血肌酐水平联合预测其肾衰的准确性分析

The accuracy of SAPS Ⅱ score combined with serum creatinine levels detection in predicting renal failure in patients with abdominal trauma

目的探讨腹部外伤患者SAPS-Ⅱ评分和血肌酐水平联合预测其肾衰的准确性。方法选取腹部外伤患者58例作为观察组,另选取同期健康查体者30例作为对照组。分析2组临床资料、SAPS-Ⅱ评分和血肌酐水平及观察组入院不同时期后SAPS-Ⅱ评分和血肌酐水平的变化及2组肾衰发生情况。采用ROC曲线分析SAPS-Ⅱ评分和血肌酐水平联合预测腹部外伤患者肾衰的准确性。结果观察组入院当天的SAPS-Ⅱ评分和血肌酐,均显著高于对照组(P<0.05);观察组入院第3、5、7、10和14天的SAPS-Ⅱ评分和血肌酐亦高于对照组且观察组入院第7、10和14天的SAPS-Ⅱ评分和血肌酐均低于入院当天,差异有统计学意义(P<0.05)。观察组肾衰发生率,显著高于对照组,差异有统计学意义(P<0.01)。SAPS-Ⅱ评分和血肌酐水平联合预测腹部外伤患者肾衰的ROC曲线下面积、敏感度和准确性分别为0.778、94.45%和99.89%,均高于SAPS-Ⅱ评分单独预测腹部外伤患者肾衰的0.602、82.43%和89.68%和血肌酐水平单独预测腹部外伤患者肾衰的0.623、85.62%和91.44%,SAPS-Ⅱ评分和血肌酐水平联合预测腹部外伤患者肾衰的准确性高,差异有统计学意义(P<0.05)。结论 SAPS-Ⅱ评分和血肌酐水平在腹部外伤中均升高且SAPS-Ⅱ评分和血肌酐水平联合预测腹部外伤患者肾衰的价值良好,出现SAPS-Ⅱ评分和血肌酐水平异常升高的腹部外伤患者需警惕其肾衰的发生。

Objective To explore the accuracy of SAPS Ⅱ score combined with serum creatinine levels detection in predicting renal failure in patients with abdominal trauma. Methods Fifty-eight patients with abdominal trauma who were admitted into our hospital from January 2013 to January 2014 were enrolled as observation group,and the other 30 healthy subjects were served as control group. The clinical data,SAPS Ⅱ score,serum creatinine levels and renal failure incidence in both groups were statistical analyzed,and ROC curve was used to analyze the accuracy of SAPS Ⅱ score combined with serum creatinine levels detection in predicting renal failure in patients with abdominal trauma. Results The SAPS Ⅱ score and serum creatinine levels in observation group on the day of admission were significantly higher than those in control group（ P〈0. 05）. The SAPS Ⅱ score and serum creatinine levels in observation group on 3d,5d,7d,10 d,14d after admission were significantly higher than those in control group（ P〈0. 05）. However the SAPS Ⅱ score and serum creatinine levels in observation group on 7d,10 d,14d after admission were significantly lower than those on the day of admission（ P〈0. 05）.The incidence of renal failure in observation group was significanyly higher than that in control group（ P〈0. 01）. The ROC area under curve,sensitivity,accuracy predicted by SAPS Ⅱ score combined with serum creatinine levels were 0. 778,94. 45%,99. 89%,respectively,which were significantly higher than those predicted by SAPS Ⅱ score only（ 0. 602,82. 43%,89. 68%,respectively）,furthermore,which were also significantly higher than those predicted by serum creatinine levels only（ 0. 623,85. 62%,91. 44%,respectively）（ P〈0. 05）. Conclusion SAPS Ⅱ score and serum creatinine levels are increased in abdominal trauma,moreover,the accuracy of combined prediction by SAPS Ⅱ score combined with serum creatinine levels is good,thereby abdominal trauma patients with high SAPS Ⅱ score and serum creatinine levels should be careful for the occurrence of renal failure.