Scr、cys C、BUN对重症急性胰腺炎并发急性肾损伤的预测效能

doi:10.3969/j.issn.1671-7171.2025.08.017

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摘要【目的】探讨肌酐(Scr)、胱抑素C(cys C)、尿素氮(BUN)对重症急性胰腺炎(SAP)并发急性肾损伤(AKI)的预测效能。【方法】89例SAP患者,根据是否发生AKI分为发生组(33例)和未发生组(56例)。比较两组患者的临床资料及Scr、cys C、BUN水平,采用单因素和多因素Logistic回归分析SAP并发AKI的影响因素;绘制受试者工作特征(ROC)曲线分析Scr、cys C、BUN对SAP并发AKI的预测效能。【结果】发生组Scr、cys C、BUN水平高于未发生组(P<0.05)。单因素分析显示,急性生理学和慢性健康状况Ⅱ(APACHEⅡ)评分、血乳酸、Ranson评分、腹腔间室综合征(ACS)、全身炎症反应综合征(SIRS)、休克、机械通气、C反应蛋白、降钙素原、血钙与并发AKI有关(P<0.05)。Logistic回归分析显示,高APACHEⅡ评分、高Ranson评分、低血钙、高Scr、高cys C、高BUN是SAP患者并发AKI独立危险因素(P<0.05)。ROC曲线分析显示,APACHEⅡ评分、Ranson评分、血钙、Scr、cys C、BUN联合预测效能高于单项指标预测。【结论】Scr、cys C、BUN在SAP并发AKI患者中水平较高,且三者联合APACHEⅡ评分、Ranson评分、血钙检测具有较好的预测价值,有助于AKI的早期识别。

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	杨玉臣
	方伟

关键词 ：胰腺炎,急性坏死性, 急性肾损伤, 血尿素氮, 抑素类

Abstract：【Objective】To evaluate the predictive value of serum creatinine (Scr), cystatin C (cys C), and blood urea nitrogen (BUN) for acute kidney injury (AKI) in patients with severe acute pancreatitis (SAP).【Methods】 A total of 89 patients with SAP were enrolled and divided into two groups based on the occurrence of AKI: the AKI group (33 cases) and the non-AKI group (56 cases). Clinical data, Scr, cys C, and BUN levels were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify risk factors for SAP complicated by AKI. Receiver operating characteristic (ROC) curves were used to analyze the predictive efficiency of Scr, cys C, and BUN.【Results】 Levels of Scr, cys C, and BUN were significantly higher in the AKI group compared to the non-AKI group (P<0.05). Univariate analysis showed that APACHE Ⅱ score, blood lactate, Ranson score, abdominal compartment syndrome (ACS), systemic inflammatory response syndrome (SIRS), shock, mechanical ventilation, C-reactive protein, procalcitonin, and serum calcium were associated with AKI occurrence (P<0.05). Multivariate logistic regression revealed that high APACHE Ⅱ score, high Ranson score, low serum calcium, elevated Scr, cys C, and BUN were independent risk factors for AKI in SAP patients (P<0.05). ROC curve analysis demonstrated that the combination of APACHE Ⅱ score, Ranson score, serum calcium, Scr, cys C, and BUN had a higher predictive value than any single indicator.【Conclusion】 Scr, cys C, and BUN levels are elevated in SAP patients with AKI. When the levels of Scr, cys C, and BUN combined with APACHE Ⅱ score, Ranson score, and serum calcium, they offer an even better predictive value for early identification of AKI in SAP.

Key words： Pancreatitis, Acute Necrotizing Acute Kidney Injury Blood Urea Nitrogen Chalones

收稿日期: 2024-10-17

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R657.51

通讯作者: ^*E-mail:396420097@qq.com

引用本文:

杨玉臣, 方伟. Scr、cys C、BUN对重症急性胰腺炎并发急性肾损伤的预测效能[J]. 医学临床研究, 2025, 42(8): 1353-1356.
YANG Yuchen, FANG Wei. Predictive Value of Scr, cys C, and BUN for Acute Kidney Injury in Severe Acute Pancreatitis. JOURNAL OF CLINICAL RESEARCH, 2025, 42(8): 1353-1356.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.08.017 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I8/1353

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