Analysis of the predictive value of monitoring NLR, PLR, CAR, albumin, serum calcium and blood glucose levels in acute kidney injury in patients with acute pancreatitis

doi:10.3877/cma.j.issn.2095-2015.2024.03.012

Abstract

Abstract:

Objective

To analyze the predictive value of monitoring neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), albumin (ALB), C-reactive protein (CRP)/ALB ratio (CAR), serum calcium and blood glucose levels in acute kidney injury (AKI) in patients with acute pancreatitis (AP).

Methods

A total of 120 AP patients admitted to Jiamusi University Hongda Hospital from October 2020 to October 2023 were included. According to the occurrence of AKI, the patients were divided into AKI group and non-AKI group. The NLR, PLR, ALB, CRP, serum calcium and blood glucose levels of the two groups were compared on admission. Logistic multivariate regression analysis and receiver operating characteristic curve (ROC) were used to calculate the predictive value of the above indicators for AKI in AP patients.

Results

Among the 120 AP patients, 31 patients had AKI, with an incidence of AKI of 25.84%. Logistic multivariate regression analysis showed that moderate to severe AP, NLR≥6, PLR≥150, ALB<35 g/L, CAR≥1.5, serum calcium<2.0 mmol/L, and blood glucose≥9.0 mmol/L were independent risk factors for AKI in AP patients (P<0.05). The AUC of AP severity combined with NLR, PLR, ALB, CAR, serum calcium, and blood glucose in predicting AKI in AP patients was 0.822, with sensitivity and specificity of 83.87% and 84.27% (P<0.05).

Conclusion

The incidence of AKI in AP patients is high, and the occurrence of AKI is closely related to the patient's condition, inflammatory status, nutritional status, blood calcium and blood glucose levels. Joint monitoring of these factors can provide reliable reference for the prediction of AKI.

Key words: Acute pancreatitis, Acute renal injury, Neutrophil-to-lymphocyte ratio, Albumin, Blood calcium, Blood glucose

Qiuzi Cui, Hongman Yao, Yingchun Ai. Analysis of the predictive value of monitoring NLR, PLR, CAR, albumin, serum calcium and blood glucose levels in acute kidney injury in patients with acute pancreatitis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(03): 244-248.

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References 19

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组别	例数	年龄(岁,±s)	性别[例(%)]		AP病情严重度[例(%)]
组别	例数	年龄(岁,±s)	男	女	轻度	中度	重度
AKI组	31	62.25±5.87	14(45.16)	17(54.84)	4(12.90)	19(61.29)	8(25.81)
非AKI组	89	59.39±6.74	43(48.31)	46(51.69)	43(48.31)	44(49.44)	2(2.25)
t/χ²值		2.1	0.092		12.1
P值		0.038	0.762		<0.001
组别	例数	监测指标(±s)
组别	例数	中性粒细胞/淋巴细胞	血小板/淋巴细胞	白蛋白(g/L)	C反应蛋白/白蛋白	血钙(mmol/L)	血糖(mmol/L)
AKI组	31	10.88±1.62	181.36±27.51	36.81±3.20	2.08±0.35	1.98±0.24	9.65±1.39
非AKI组	89	5.11±0.48	125.28±16.47	41.15±4.03	0.31±0.04	2.13±0.31	7.02±0.88
t/χ²值		30.204	13.535	5.425	47.196	2.448	12.199
P值		<0.001	<0.001	<0.001	<0.001	0.016	<0.001

组别	例数	年龄(岁,±s)	性别[例(%)]		AP病情严重度[例(%)]
组别	例数	年龄(岁,±s)	男	女	轻度	中度	重度
AKI组	31	62.25±5.87	14(45.16)	17(54.84)	4(12.90)	19(61.29)	8(25.81)
非AKI组	89	59.39±6.74	43(48.31)	46(51.69)	43(48.31)	44(49.44)	2(2.25)
t/χ²值		2.1	0.092		12.1
P值		0.038	0.762		<0.001
组别	例数	监测指标(±s)
组别	例数	中性粒细胞/淋巴细胞	血小板/淋巴细胞	白蛋白(g/L)	C反应蛋白/白蛋白	血钙(mmol/L)	血糖(mmol/L)
AKI组	31	10.88±1.62	181.36±27.51	36.81±3.20	2.08±0.35	1.98±0.24	9.65±1.39
非AKI组	89	5.11±0.48	125.28±16.47	41.15±4.03	0.31±0.04	2.13±0.31	7.02±0.88
t/χ²值		30.204	13.535	5.425	47.196	2.448	12.199
P值		<0.001	<0.001	<0.001	<0.001	0.016	<0.001

变量名	变量	赋值
Y	急性肾损伤	未发生=0，发生=1
X1	年龄	<60岁=0，≥60岁=1
X2	急性胰腺炎病情严重度	轻度=0，中重度=1
X3	中性粒细胞/淋巴细胞比值	<6=0，≥6=1
X4	血小板/淋巴细胞比值	<150=0，≥150=1
X5	白蛋白	≥35 g/L=0，<35 g/L=1
X6	C反应蛋白/白蛋白比值	<1.5=0，≥1.5=1
X7	血钙	≥2.0 mmol/L=0，<2.0 mmol/L=1
X8	血糖	<9.0 mmol/L=0，≥9.0 mmol/L=1

变量名	变量	赋值
Y	急性肾损伤	未发生=0，发生=1
X1	年龄	<60岁=0，≥60岁=1
X2	急性胰腺炎病情严重度	轻度=0，中重度=1
X3	中性粒细胞/淋巴细胞比值	<6=0，≥6=1
X4	血小板/淋巴细胞比值	<150=0，≥150=1
X5	白蛋白	≥35 g/L=0，<35 g/L=1
X6	C反应蛋白/白蛋白比值	<1.5=0，≥1.5=1
X7	血钙	≥2.0 mmol/L=0，<2.0 mmol/L=1
X8	血糖	<9.0 mmol/L=0，≥9.0 mmol/L=1

影响因素	β	SE(β)	Wald χ²值	P值	OR	95% CI
年龄≥60岁	0.032	0.028	1.306	0.225	1.033	0.977~1.091
中重度急性胰腺炎	1.583	0.462	11.740	<0.001	4.870	1.969~12.043
中性粒细胞/淋巴细胞≥6	0.396	0.099	16.000	<0.001	1.486	1.224~1.804
血小板/淋巴细胞≥150	1.089	0.275	15.682	0.012	2.971	1.733~5.094
白蛋白<35 g/L	1.143	0.525	4.740	0.003	3.136	1.121~8.776
C反应蛋白/白蛋白≥1.5	1.406	0.338	17.304	0.002	4.080	2.103~7.913
血钙<2.0 mmol/L	1.639	0.699	5.498	<0.001	5.150	1.309~20.268
血糖≥9.0 mmol/L	0.282	0.098	8.280	0.016	1.326	1.094~1.607

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