Predictive value of prognostic nutritional index combined with PCT,CysC,and RBP levels for acute pancreatitis complicated with acute kidney injury
Objective To investigate the predictive value of prognostic nutritional index(PNI),serum procalcitonin(PCT),serum cystatin C(CysC),and serum retinol binding protein(RBP)for patients with acute pancreatitis(AP)complicated with acute kidney injury(AKI).Methods A retrospective analysis was conducted on 350 patients with AP admitted to Wuxi Xishan People's Hospital from June 2022 to June 2024.Patients were divided into two groups based on whether they had concurrent AKI:the AP group and the AP+AKI group.The differences in PNI,PCT,CysC,and RBP levels between the two groups were compared,and their correlations with AP evaluation indicators APACHE Ⅱ score,Ranson score,and Balthazar CTSI score were analyzed through Spearson analysis.The predictive abilities of PNI,PCT,CysC,and RBP levels for AP combined with AKI were evaluated through ROC curve and multivariate logistic analysis.Results The PNI level,APACHE Ⅱ score,Ranson score,and Balthazar CTSI of patients in the AP group were significantly higher than those in the AP+AKI group,while the serum PCT,CysC,and RBP levels were significantly lower than those in the AP+AKI group(P<0.05);Spearson correlation analysis showed that PNI was negatively correlated with APACHE Ⅱ score,Ranson score,and Balthazar CTSI score,while PCT,CysC,and RBP were positively correlated with APACHE Ⅱ score,Ranson score,and Balthazar CTSI score(P<0.05).The ROC curve showed that the area under the PNI+PCT+CysC+RBP joint curve was 0.923,with a 95％confidence interval of 0.861-0.984(P<0.05).Multivariate logistic analysis showed that PNI[OR=0.425,95％CI(0.193-0.755)],PCT[OR=4.632,95％CI(2.131-5.085)],CysC[OR=2.076,95％CI(1.635-2.978)],and RBP[OR=3.261,95％CI(2.478-4.639)]were independent risk factors for AKI in AP patients.Conclusion PNI,PCT,CysC,and RBP levels can be used as indicators for predicting AKI in AP patients,which are conducive to early detection of high-risk patients with AP prone to AKI,optimization of treatment strategies,and improvement of patient prognosis,and have high clinical significance for promotion.
Acute pancreatitisAcute kidney injuryPrognostic nutritional indexProcalcitoninCystatin CRetinol binding protein
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维普
