急性胰腺炎并发肺栓塞的影响因素研究

Influencing factors of acute pancreatitis complicated with pulmonary embolism

目的探讨急性胰腺炎(acute pancreatitis,AP)并发肺栓塞(pulmonary embolism,PE)的危险因素,从而指导临床早期发现PE患者。方法回顾性分析2015年1月至2020年10月昆明医科大学第二附属医院病历资料完整且行CT肺血管成像(CTPA)检查的住院治疗AP患者133例。根据是否有PE分为两组:PE组和无PE组。比较两组的一般资料、手术情况、中心静脉置管情况、症状、体征、血常规、生化指标、胰腺功能指标、凝血功能、感染指标。采用多因素logistic回归分析,分析AP并发PE的影响因素。结果133例AP患者中,并发PE 61例(PE组),不并发PE 72例(无PE组)。PE组与无PE组胸腔积液发生率、DD、PCT高于无PE组,ALB低于无PE组(P<0.05)。多因素logistic多因素回归分析结果显示DD是AP并发PE的独立影响因素(P<0.05)。ROC曲线结果显示,DD预测AP患者并发PE的ROC曲线下面积是0.756,其临界值为5.275,其灵敏度为0.689,特异度为0.847。结论DD是AP并发PE的独立危险因素,当DD大于5.275时应高度警惕PE的发生。

Objective To investigate the risk factors of acute pancreatitis(AP)complicated with pulmonary embolism(PE),so as to direct the early clinical detection of PE patients.Methods Retrospective analysis was performed on 133 AP patients with complete medical records and underwent CTPA examination in the Second Affiliated Hospital of Kunming Medical University from January 2015 to October 2020.According to whether there was PE,the patients were divided into two groups:the PE group and the non-PE group.Their general data,operation,central venous catheterization,symptoms,signs,blood routine,biochemical indexes,pancreatic function,coagulation function,and infection indexes were compared between the two groups.Multivariate logistic analysis was used to analyze the influencing factors of AP complicated with PE.Results Among 133 AP patients,there were 61 cases with PE(the PE group)and 72 cases without PE(the non-PE group).The incidence of pleural effusion,DD and PCT in the PE group were higher than those in the non-PE group,ALB was lower in the non-PE group than that in the PE group(P<0.05).Multivariate logistic analysis showed that DD was an independent risk factor for AP complicated with PE(P<0.05).The ROC curve results showed that the area under the ROC curve of DD predicting PE in AP patients was 0.756,with critical value of 5.275,sensitivity of 0.689,and specificity of 0.847.Conclusion DD is an independent risk factor for AP concurrent PE.When DD is higher than 5.275,the occurrence of PE should be warned.