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Value of serum cystatin C in predicting acute kidney injury in patients with acute pancreatitis
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摘要:
目的探索血清胱抑素C在早期预测急性胰腺炎（AP）并发急性肾损伤（AKI）中的价值。方法回顾性分析2013年1月-2018年8月西南医科大学附属医院收治的273例AP患者的临床资料,其中45例患者合并AKI（AKI组）,228例患者未合并AKI （非AKI组）。收集所有患者的性别、年龄、淀粉酶、脂肪酶、血清肌酐、尿素、尿酸、胱抑素C、甘油三酯、高密度脂蛋白胆固醇、血细胞比容、C-反应蛋白、ALT、血清钙离子、白细胞计数等指标。计量资料不满足正态分布两组间比较采用Mann-Whitney U检验。计数资料两组间比较采用χ2检验。将单因素分析中有统计学意义的变量进行多因素logistic回归分析,受试者工作特征曲线用于评价指标的诊断效能,Spearman相关性分析用于评价数据间的相关性。结果年龄（Z=-2.746,P=0.006）、性别（χ2=4.080,P=0.043）、淀粉酶（Z=-5.040,P<0.001）、脂肪酶（Z=-4.399,P <0.001）、血清肌酐（Z=-10.241,P <0.001）、尿素（Z=-8.2...
Abstract:Objective To investigate the value of serum cystatin C in the early prediction of acute kidney injury( AKI) in patients with acute pancreatitis( AP). Methods A retrospective analysis was performed for the clinical data of 273 patients with AP who were admitted to The Affiliated Hospital of Southwest Medical University from January 2013 to August 2018,among whom there were 45 patients with AKI( AKI group) and 228 without AKI( non-AKI group). Related indicators were collected from all patients,including sex,age,amylase,lipase,serum creatinine,blood urea nitrogen,serum uric acid,serum cystatin C,triglyceride,high-density lipoprotein cholesterol,hematocrit,C-reactive protein,alanine aminotransferase,serum calcium,and white blood cell count. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups. The variables with statistical significance in the univariate analysis were included in the multivariate logistic regression analysis,and the receiver operating characteristic( ROC) curve was used to evaluate the diagnostic efficiency of indicators. A Spearman correlation analysis was used to evaluate the correlation between data. Results There were significant differences between the two groups in age( Z =-2. 746,P = 0. 006),sex( χ2= 4. 080,P = 0. 043),amylase( Z =-5. 040,P < 0. 001),lipase( Z =-4. 399,P < 0. 001),serum creatinine( Z =-10. 241,P < 0. 001),blood urea nitrogen( Z =-8. 295,P < 0. 001),uric acid( Z =-7. 974,P < 0. 001),serum cystatin C( Z =-9. 312,P < 0. 001),and serum calcium( Z =-4. 271,P < 0. 001). The multivariate logistic regression analysis showed that serum cystatin C( odds ratio [OR]= 7. 871,95% confidence interval [CI]: 3. 406-18. 190,P < 0. 001),uric acid( OR =1. 007,95% CI: 1. 003-1. 011,P = 0. 001),and serum calcium( OR = 0. 112,95% CI: 0. 023-0. 540,P = 0. 006) were independent influencing factors for AKI in patients with AP. Serum cystatin C had an area under the ROC curve of 0. 939,a sensitivity of 0. 889,and a specificity of 0. 904 in predicting AKI in patients with AP. The Spearman correlation analysis showed that cystatin C was strongly correlated with creatinine( r = 0. 741,P < 0. 001). Conclusion Serum cystatin C is an important predictive factor for AKI in patients with AP.
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Key words:
- pancreatitis /
- acute kidney injury /
- cystatin C
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