Edgar Bravo-Santibáñez, Martha Alicia Hernández-González, Sergio López-Briones, Marisol Contreras-Chávez
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引用次数: 0
摘要
背景:急性肾损伤(AKI)常见于脓毒症(25 ~ 51%),死亡率高(40 ~ 80%),并伴有长期并发症。尽管它很重要,但我们在重症监护中没有可访问的标记。在其他实体(手术后和COVID-19)中,中性粒细胞/淋巴细胞和血小板(N/LP)比率与急性肾损伤有关;然而,这种关系尚未在脓毒症等严重炎症反应的病理中进行研究。目的:探讨重症监护中N/LP与脓毒症继发AKI的关系。材料和方法:在18岁以上诊断为败血症的重症监护患者中进行双视角队列研究。从入院到第7天,直到AKI诊断和结果,计算N/LP比率。统计学分析采用卡方检验、克莱默V检验和多元logistic回归。结果:在研究的239例患者中,70%的患者发生了AKI。N/LP比值> 3的患者中有80.9%发生AKI (p < 0.0001, Cramer's V 0.458, OR 3.05, 95% CI 1.602-5.8),并增加了肾脏替代治疗(21.1比11.1%,p = 0.043)。结论:重症监护室N/LP比值> 3与脓毒症继发AKI有中度相关性。
[Association of neutrophil, lymphocyte, platelet ratio with acute kidney injury in sepsis].
Background: Acute kidney injury (AKI) is frequent in sepsis (25 to 51%), with high mortality (40 to 80%) and long-term complications. Despite its importance we do not have accessible markers in intensive care. In other entities (post-surgical and COVID-19) the neutrophil/lymphocyte and platelet (N/LP) ratio has been associated with acute kidney injury; however, this relationship has not been studied in a pathology with a severe inflammatory response such as sepsis.
Objective: To demonstrate the association between N/LP with AKI secondary to sepsis in intensive care.
Material and methods: Ambispective cohort study in patients over 18 years who were admitted to intensive care with a diagnosis of sepsis. The N/LP ratio was calculated from admission up to the seventh day and up to the diagnosis of AKI and outcome. Statistical analysis was performed with chi squared test, Cramer's V and multivariate logistic regression.
Results: Out of the 239 patients studied, the incidence of AKI developed in 70%. 80.9% of patients with N/LP ratio > 3 had AKI (p < 0.0001, Cramer's V 0.458, OR 3.05, 95% CI 1.602-5.8) and increased renal replacement therapy (21.1 vs. 11.1%, p = 0.043).
Conclusion: N/LP ratio > 3 has a moderate association with AKI secondary to sepsis in the intensive care unit.