RRI、CAR及SII与重症急性胰腺炎并发急性肾损伤的相关性分析

Correlation of renal vascular resistance index,C-reactive protein to albumin ratio,and systemic immune inflammation index with severe acute pancreatitis complicated by acute kidney injury

目的探讨肾血管阻力指数(RRI)、C-反应蛋白与白蛋白比值(CAR)及全身免疫炎症指数(SII)与重症急性胰腺炎并发急性肾损伤(AKI)的相关性。方法选取2020年7月—2022年8月于本院收治的合并AKI重症急性胰腺炎患者28例(AKI组)和未并发AKI重症急性胰腺炎患者64例(非AKI组),共计92例重症急性胰腺炎患者作为研究对象,并设立为观察组,同期选取46例健康体检者设立为对照组,对比RRI、CAR及SII指标。采用Logistic回归模型分析重症急性胰腺炎并发AKI的危险因素,并用ROC曲线模型评估RRI、CAR、SII预测AKI的AUC、敏感度、特异度。结果观察组RRI、CAR及SII均高于对照组,差异具有统计学意义(P<0.05)。AKI组RRI、CAR及SII均高于非AKI组,差异具有统计学意义(P<0.05)。Logistic回归模型分析显示,RRI、CAR、SII水平升高会对重症急性胰腺炎患者并发AKI产生影响因素,差异具有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示,RRI、CAR、SII及三项联合预测重症急性胰腺炎患者并发AKI的曲线下面积(AUC)分别为0.789、0.813、0.823、0.907(P<0.05),敏感度分别为57.10%、50.00%、64.30%、92.90%;特异度分别为98.40%、95.30%、90.60%、84.40%。结论RRI、CAR及SII在重症急性胰腺炎患者并发AKI中呈升高趋势,检测其变化可为预测AKI的发生提供参考。

Objective To explore the correlation of renal vascular resistance index(RRI),C-reactive protein to albumin ratio(CAR)and systemic immune inflammation index(SII)with severe acute pancreatitis complicated with acute kidney injury(AKI).Methods 28 patients with severe acute pancreatitis complicated with AKI(AKI group)and 64 patients without AKI(non AKI group)admitted to our hospital from July 2020 to August 2022 were selected as the study subjects,with a total of 92 patients with severe acute pancreatitis as the observation group.During the same period,46 healthy examinees were selected as the control group,and RRI,CAR,and SII indicators were compared.Using logistic regression model to analyze the risk factors of severe acute pancreatitis complicated with AKI,and using ROC curve model to evaluate the AUC,sensitivity,and specificity of RRI,CAR,and SII in predicting AKI.Results RRI,CAR and SII in the observation group were higher than those in the control group(P<0.05).RRI,CAR and SII were higher in the AKI group than those in the non-AKI group(P<0.05).Logistic regression model analysis showed that the increased RRI,CAR,and SII levels could affect the concurrent AKI in patients with severe acute pancreatitis(P<0.05).ROC curve analysis showed that the AUC values of RRI,CAR,SII and the combination in predicting AKI in patients with severe acute pancreatitis were 0.789,0.813,0.823,0.907(P<0.05),and the sensitivity were 57.10%,50.00%,64.30%,92.90%,respectively,the specificity was 98.40%,95.30%,90.60% and 84.40%.Conclusion RRI,CAR and SII are increased in severe acute pancreatitis patients.Change is beneficial to provid ereference for predicting the occurrence of AKI.