急性胰腺炎患者血脂异常与急性肾损伤的关联性

Association between dyslipidemia and acute kidney injury in patients with acute pancreatitis

目的探讨急性胰腺炎(AP)患者血脂异常与急性肾损伤(AKI)的关联性。方法前瞻性收集AP患者120例,根据患者住院期间有无合并AKI将患者分为AKI组和无AKI组,观察两组患者的血脂水平和其他临床特征。结果与无AKI组比较,AKI组患者高胆固醇血症发生率更高,胆源性AP发生率更低,其他类型AP发生率更高,差异均有统计学意义(χ^2分别=5.42、10.29、4.30,P均<0.05),AKI组患者的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白A1(Apo-A1)水平均高于无AKI组,高密度脂蛋白胆固醇(HDL-C)水平低于无AKI组,差异均有统计学意义(t分别=3.83、9.81、6.14、5.61、2.75,P均<0.05);急性生理与慢性健康评分(APACHEⅡ)评分、序贯器官衰竭估计评分(SOFA)评分、Ranson评分、住院时间、多脏器功能损伤、腹腔感染、外科引流率和院内死亡率明显增加,差异均有统计学意义(t分别=3.70、6.57、6.13、12.02,χ^2=42.99、21.07、23.71、12.60,P均<0.05)。进一步危险因素分析,高胆固醇血症、TC、TG、LDL-C、Apo-A1、APACHEⅡ评分、SOFA评分和Ranson评分增高是AP患者并发AKI的危险因素(OR分别=1.44、1.52、1.45、1.25、1.60、1.69、1.67、1.65,P均<0.05)。结论高脂血症是AP患者发生AKI的危险因素。

Objective To investigate the association between dyslipidemia and acute kidney injury(AKI)in patients with acute pancreatitis.Methods A total of 120 patients with acute pancreatitis were prospectively enrolled.According to whether occurred acute kidney injury during hospitalization or not,patients were divided into AKI group and non AKI group.The blood lipid level and other clinical features of the two groups of patients were observed.Results Compared with the non AKI group,the incidence of hypercholesterolemia and cholesterol-derived AP of AKI group were higher,the incidence of other types of AP was lower,total cholesterol(TC)level was higher,triglyceride(TG)level was higher,high density lipoprotein cholesterol(HDL-C)level was lower,low density lipoprotein cholesterol(LDL-C)level was higher,apolipoprotein A1(Apo-A1)level was higher,the differences were statistically significant(χ^2=5.42,10.29,4.30,t=3.83,9.81,6.14,5.61,2.75,P<0.05).The APACHEⅡ,SOFA score,Ranson score,hospitalization time,multiple organ dysfunction,abdominal infection,surgical drainage rate and hospital mortality of AKI group increased significantly(t=3.70,6.57,6.13,12.02,χ^2=42.99,21.07,23.71,12.60,P<0.05).Hypercholesterolemia,TC,TG,LDL-C,Apo-A1,APACHE II,increased SOFA score and Ranson score were risk factors for AKI in patients with acute pancreatitis(OR=1.44,1.52,1.45,1.25,1.60,1.69,1.67 and 1.65,P<0.05).Conclusion Hyperlipidemia is a risk factor for AKI in patients with acute pancreatitis.