肾阻力指数联合血液指标对急性胰腺炎并发急性肾损伤的预测价值OACSTPCD

Objective To explore the predictive value of renal resistance index(RRI)evaluated by ultrasound combined with blood indices in acute pancreatitis(AP)complicated with acute kidney injury(AKI).Methods Patients with AP admitted to the Second People's Hospital of Anhui Province from June 2021 to January 2024 were divided into AKI group and non-AKI group according to whether AKI occurred within 7 d after admission.RRI was evaluated by ultrasonography after collecting the basic information,scores of Acute Physiologic Assessment and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)and Sequential Organ Failure Assessment(SOFA)within 24 h after admission,blood indices such as serum creatinine(sCr),blood urea nitrogen(BUN),serum cystatin C(Cys C),red blood cell distribution width(RDW)and C-reactive protein(CRP)within 24 h after admission were collected.Univariate analysis and multivariate logistic regressions were used to analyze the risk factors of AKI.The receiver operating characteristic(ROC)curves were drawn to analyze the predictive values of RRI combined with blood indices.Results A total of 145 patients were included,including 37 patients with AKI and 108 patients without AKI.APACHE Ⅱ score,SOFA score,Cys C,RDW,CRP and RRI in AKI group were higher than those in non-AKI group(P＜0.05).Multivariate logistic regression analysis showed that Cys C(OR=5.458,95％CI 1.275-23.369),CRP(OR=5.296,95％CI 1.676-16.734)and RRI(OR=6.114,95％CI 2.966-12.602)increased were the risk factors of AKI in patients with AP(P＜0.05).ROC curve analysis showed that the area under curve(AUC)of Cys C,CRP and RRI for predicting AKI in patients with AP were 0.648(95％CI 0.540-0.756,P=0.011),0.777(95％CI 0.694-0.859,P＜0.001)and 0.802(95％CI 0.710-0.893,P＜0.001),respectively.AUC of combination of the three indices was 0.909,the sensitivity was 96.55％,and the specificity was 72.41％.Conclusions Cys C,CRP and RRI increasing are all risk factors of AP patients complicating with AKI,and all of them have certain predictive value.The combination of the three indices is of high value in predicting AP patients complicating with AKI.