血尿酸/血肌酐比值对重症急性胰腺炎患者急性肾损伤的预测分析

Predictive analysis of blood uric acid/serum creatinine ratio on acute kidney injury in patients with severe acute pancreatitis

目的分析血尿酸(BUA)/血肌酐(Scr)比值对重症急性胰腺炎患者急性肾损伤(AKI)的预测价值,为AKI的防治提供理论依据。方法本研究为回顾性研究,病例来源于杭州市第一人民医院2019年5月—2022年6月收治的83例重症急性胰腺炎患者。收集患者基线资料及实验室资料,检测并计算BUA/Scr比值;分别于入院24 h、入院7 d评估重症急性胰腺炎患者AKI发生情况并分组;分析BUA/Scr比值对重症急性胰腺炎患者AKI的预测价值。结果83例重症急性胰腺炎患者AKI发生率为21.69%(18/83);AKI组尿蛋白阳性占比高于非AKI组,BUA、Scr及BUA/Scr比值高于非AKI组,差异有统计学意义(P<0.05);组间其他基线资料及实验室资料对比,差异无统计学意义(P>0.05);经Point-biserial相关性分析显示,BUA、Scr及BUA/Scr与重症急性胰腺炎患者AKI成正相关(r>0,P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,BUA、Scr及BUA/Scr预测重症急性胰腺炎患者AKI的曲线下面积(AUC)均>0.7,且以BUA/Scr预测价值最佳。结论BUA/Scr比值可有效预测重症急性胰腺炎患者AKI的发生,建议临床可根据BUA/Scr比值制定防治措施,以降低AKI发生率。

Objective This paper aims to analyze the predictive value of blood uric acid(BUA)/serum creatinine(Scr)ratio on acute kidney injury(AKI)in patients with severe acute pancreatitis(SAP),so as to provide theoretical basis for the prevention and treatment of AKI.Methods This study is a retrospective study.The cases were from 83 patients with severe acute pancreatitis admitted to Hangzhou First People's Hospital from May 2019 to June 2022.After admission,the baseline data and laboratory data of patients were collected,and BUA/Scr ratio was detected and calculated.The incidence of AKI in patients with severe acute pancreatitis was evaluated and divided into groups at 24 h and 7 d after admission respectively.The predictive value of BUA/Scr ratio on AKI in patients with severe acute pancreatitis were analyzed.Results The incidence of AKI in 83 patients with severe acute pancreatitis was 21.69%(18/83).The percentage of positive urinary protein in AKI group was higher than that in non AKI group,and the BUA,Scr and BUA/Scr ratio were higher than those in non AKI group,with the difference statistically significant(P<0.05).There was no statistical significance on difference in other baseline data and laboratory data between groups(P>0.05).Point-biserial correlation analysis showed that BUA,Scr and BUA/Scr were positively correlated with AKI in patients with severe acute pancreatitis(r>0,P<0.05).The ROC curve of subjects was drawn.The results showed that the area under the curve(AUC)of BUA,Scr and BUA/Scr for predicting AKI in patients with severe acute pancreatitis was greater than 0.7,and BUA/Scr had the best predictive value.Conclusion BUA/Scr ratio can effectively predict the occurrence of AKI in patients with severe acute pancreatitis.It is suggested that prevention and treatment measures can be formulated according to BUA/Scr ratio in the future to reduce the incidence of AKI.