脓毒症患者继发急性肾损伤危险因素Logistic回归方程研究

Study on Logistic regression analysis of risk factors for secondary acute kidney injury in patients with sepsis

目的分析脓毒症患者继发急性肾损伤的危险因素,并构建回归方程。方法回顾性收集2020年3月—2022年7月106例脓毒症患者临床资料,根据是否继发急性肾损伤分为急性肾损伤组(49例)和非急性肾损伤组(57例)。采用多因素Logistic回归分析脓毒症患者继发急性肾损伤的危险因素,并构建回归方程,采用受试者工作特征曲线(ROC)分析回归方程对脓毒症患者继发急性肾损伤的预测价值。结果合并肺部感染、平均动脉压(MAP)较低、尿量较少、动脉血酸碱度(pH)较低、血清胱抑素C(Cys-C)水平较高、急性生理和慢性健康状况(APACHEII)评分较高均为脓毒症患者继发急性肾损伤的独立危险因素(P<0.05)。logit(P)=-11.027+合并肺部感染×1.372+MAP×1.125+尿量×0.983+动脉血p H×1.083+血清Cys-C水平×1.362+APACHEII评分×0.983。ROC曲线分析结果显示,当logit(P)>15.06时,AUC为0.900,敏感度为70.21%,特异度为94.06%。结论脓毒症患者继发急性肾损伤的独立危险因素较多,据此构建回归方程对脓毒症患者继发急性肾损伤具有较好的预测价值。

Objective To analyze the risk factors of secondary acute kidney injury in patients with sepsis and construct regression equations.Methods The clinical data of 106 sepsis patients admitted to the First People's Hospital of Anqing Affiliated to Anhui Medical University from March 2020 to July 2022 were retrospectively analyzed.The patients were divided into the acute kidney injury group(49 cases)and the non acute kidney injury group(57 cases)according to whether they had secondary acute kidney injury.Multivariate Logistic regression was used to analyze the risk factors of secondary acute kidney injury in patients with sepsis,and the regression equation was constructed.The receiver operating characteristic(ROC)was used to analyze the predictive value of regression equation for secondary acute kidney injury in patients with sepsis.Results Complicated with pulmonary infection,lower mean arterial pressure(MAP),less urine volume,lower arterial pH(pH)value,higher serum Cystatin C(Cys-C)level,and higher acute physiological and chronic health evaluation II(APACHEII)score were all independent risk factors for secondary acute kidney injury in sepsis patients(P<0.05).Logit(P)=-11.027+complicated with pulmonary infection×1.372+MAP×1.125+urine volume×0.983+arterial pH value×1.083+serum Cys-C level×1.362+APACHEII score×0.983.ROC curve analysis showed that when logit(P)>15.06,area under curve(AUC)value was 0.900,sensitivity was 70.21%,and specificity was 94.06%.Conclusion There are many independent risk factors for secondary acute kidney injury in patients with sepsis.Therefore,the construction of regression equation has a good value in predicting secondary acute kidney injury in patients with sepsis.