NLR和PLR以及CAR联合血清胱抑素C对急性胰腺炎合并急性肾损伤的预测价值

李平; 王东; 代小雨; 刘文君; 刘文

doi:10.13201/j.issn.1009-5918.2021.09.005

NLR和PLR以及CAR联合血清胱抑素C对急性胰腺炎合并急性肾损伤的预测价值

- 1. 西南医科大学附属医院胃肠外科(四川泸州,646000);
- 2. 绵阳市中心医院MDT平台肾病内科;
- 3. 绵阳市中心医院外科;
- 4. 绵阳市中心医院普外科
基金项目:
四川省医学科研课题计划(No:S18016)

详细信息

通讯作者: 王东,E-mail:zxyy61898@126.com

中图分类号: R657.51

收稿日期: 2021-07-08

The predicitive value of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio and C-reactive protein/albumin ratio and serum cystatin C for acute pancreatitis with acute kidney injury

- 1 Department of Gastrointestinal Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China;
- 2 Department of Nephrology, Mianyang Central Hospital;
- 3 Department of Surgery, Mianyang Central Hospital;
- 4 Department of Gastrointestinal Surgery, Mianyang Central Hospital

More Information

Corresponding author: WANG Dong, E-mail: zxyy61898@126.com

Received Date: 08 July 2021

摘要

摘要: 目的:探索中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、C反应蛋白/白蛋白(CAR)联合血清胱抑素C(Cys C)对急性胰腺炎(AP)并发急性肾损伤(AKI)的预测价值。方法:回顾性分析2016年4月-2021年4月期间在四川省绵阳市中心医院住院治疗的393例AP患者的临床资料,其中328例患者未合并AKI(非AKI组),65例患者合并AKI(AKI组)。收集所有患者的病例资料、临床指标并进行统计学分析。结果:性别、氯离子、血小板计数(PLT)、淀粉酶(AMY)、脂肪酶(LPS)组间相比差异无统计学意义(P>0.05);年龄、血肌酐(SCr)、血尿素氮(BUN)、尿酸(UA)、估算肾小球滤过率(eGFR)、钙离子、Cys C、C反应蛋白(CRP)、白蛋白(Alb)、白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)、NLR、PLR、CAR、红细胞比容(HCT)组间比较差异均有统计学意义(P<0.05)。二元Logistic回归分析发现,NLR、PLR、CAR、Cys C是AP合并AKI的重要影响因素(P<0.05)。ROC曲线结果显示NLR预测AP合并AKI的曲线下面积为0.867,特异度为0.692,敏感度为0.923。PLR预测AP合并AKI的曲线下面积为0.741,特异度为0.720,敏感度为0.677。CAR预测AP合并AKI的曲线下面积为0.843,特异度为0.851,敏感度为0.785。Cys C预测AP合并AKI的曲线下面积为0.954,特异度为0.942,敏感度为0.862。结论:Cys C、CAR、NLR、PLR在预测AP患者并发AKI中具有重要的预测价值,有一定的临床意义。
- 急性胰腺炎 /
- 急性肾损伤 /
- 中性粒细胞/淋巴细胞 /
- 血小板/淋巴细胞 /
- C反应蛋白/白蛋白 /
- 胱抑素C
Abstract: Objective: To explore the predictive value of neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR), C-reactive protein/albumin ratio(CAR) and serum cystatin C(Cys C) in acute pancreatitis(AP) with acute kidney injury(AKI).Methods: The clinical data of 393 patients with AP hospitalized in Mianyang Central Hospital from April 2018 to April 2021 were analyzed retrospectively. Among them, 328 patients did not have AKI(non-AKI group), and 65 patients had AKI(AKI group). The case data and clinical indexes of all patients were collected and statistically analyzed.Results: There was no significant difference between the two groups in gender, chloride ion, platelet(PLT), amylase(AMY) and lipase(LPS)(P>0.05). There were significant differences between the two groups in age, serum creatinine(SCr), blood urea nitrogen(BUN), uric acid(UA), estimated glomerular filtration rate(eGFR), calcium ion, Cys C, C-reactive protein(CRP), albumin(Alb), white blood cell(WBC), neutrophil(NEUT), lymphocyte(LYM), NLR, PLR, CAR, and hematocrit(HCT)(P<0.05). The analysis of binary Logistic regression found that, NLR, PLR, CAR and Cys C are the important influencing factors of AP merging AKI(P<0.05). NLR had an area under the ROC curve of 0.867, a specificity of 0.692 and a sensitivity of 0.923 in predicting AKI in patients with AP. PLR had an area under the ROC curve of 0.741, a specificity of 0.720 and a sensitivity of 0.677 in predicting AKI in patients with AP. CAR had an area under the ROC curve of 0.843, a specificity of 0.851 and a sensitivity of 0.785 in predicting AKI in patients with AP. Cys C had an area under the ROC curve of 0.954, a specificity of 0.942 and a sensitivity of 0.862 in predicting AKI in patients with AP.Conclusion: NLR, PLR, CAR and Cys C have important predictive value and clinical significance in predicting AKI in patients with AP.
- Acute pancreatitis /
- Acute kidney injury /
- Neutrophil/lymphocyte ratio /
- Platelet/lymphocyte ratio /
- C-reactive protein/albumin ratio /
- Cystatin C

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