急性胰腺炎合并糖尿病酮症酸中毒的临床预后影响因素分析

Clinical prognostic factors of diabetic ketoacidosis complicated with acute pancreatitis

目的探讨急性胰腺炎(acute pancreatitis,AP)合并糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的临床预后影响因素.方法选取2017年1月至2020年12月期间于我院就诊的58例AP合并DKA患者为研究对象,根据预后分为死亡组与存活组.比较两组临床资料,采用多因素logistics回归分析筛选出死亡发生的独立影响因素.结果全部58例患者共有15例患者死亡,病死率为25.9%,归为死亡组,其余43例患者归为存活组.死亡组患者的年龄、入院时的血甘油三酯(triglyceride,TG)、超敏C反应蛋白、入院后24h的休克、感染发生率及序贯性器官功能衰竭评分(Sequential Organ Failure As-sessment,SOFA)显著高于存活组,血钠、钙、血pH值显著低于存活组,差异有统计学意义(P<0.05).多因素logistic回归分析结果表明入院时的血TG、钙水平、入院后24h的SOFA评分是死亡发生的独立影响因素(P<0.05).结论AP合并DKA患者的临床整体预后并不理想,入院时的血TG、钙水平、入院后24h的SOFA评分是患者死亡发生的独立影响因素.

Objective To investigate the clinical prognosUc factors of acute pancreatitis(AP)complicated with diabetic ketoacidosis(DKA).Methods Fifty-eightAP patients complicated with DKA from January 2017 to December 2020 in our hospital were enrolledfor the research and divided into death group and survival group according to the prognosis.The clinical data were compared between two groups,and multivariate logistic regression analysis was performed to screen out the independent influencing factors of death.Results In all 58 patients,15 patients died as death group with a mortality rate of 25.9%,and the remaining 43 patients were classified as survival group.The age,blood levels of triglyceride(TG),high-sensitivity C-reactive protein at admission,the incidences of shock,infection and sequential organ failure assessment(SOFA)score at 24h after admission in death group were significantly higher than those in survival group,and the blood levels of sodium,calcium and pH were significantly lower than those in survival group(P<0.05).Multivariate logistic regression analysis showed that blood levels of TG,calcium at admission and SOFA score at 24h after admission were the independent factors of death(F<0.05).Conclusions The overall clinical prognosis of AP patients complicated with DKA was not ideal.The blood levels of TG,calcium at admission and SOFA score at 24h after admission were-the independent factors of death.