摘要
目的探讨甘油三酯葡萄糖体质量指数(TyG-BMI)对高脂血症性急性胰腺炎(HLAP)严重程度的预测价值。方法回顾性分析武汉科技大学附属天佑医院2021年1月—2023年12月收治入院的185例HLAP患者临床资料。根据修订的亚特兰大急性胰腺炎分级标准分为轻症组95例和中重症组90例,比较两组患者的临床特征,分析TyG-BMI与HLAP严重程度的相关性,评估TyG-BMI对于HLAP严重程度的预测效能。计量资料两组间比较采用成组t检验或Mann-Whitney U检验。计数资料两组间比较采用χ^(2)检验。单因素和多因素Logistic回归分析HLAP严重程度的影响因素。应用Spearman相关性分析探讨TyG-BMI与HLAP严重程度的关系。采用受试者工作特征曲线配对比较法对TyG-BMI预测HLAP严重程度的效能进行评估。结果轻症组和中重症组患者Cr、GLU、TG、TyG-BMI、BISAP评分比较,差异均有统计学意义(Z值分别为−2.059、−7.217、−7.799、−9.566、−11.386,P值均<0.05)。多因素Logistic回归分析结果显示,BISAP评分(OR=4.221,95%CI:1.421~12.538,P=0.001)、TyG-BMI(OR=1.262,95%CI:1.140~1.396,P=0.010)和GLU(OR=1.316,95%CI:1.040~1.666,P=0.022)是HLAP严重程度的独立危险因素,且均与HLAP的严重程度呈正相关(r值分别为0.839、0.705、0.532,P值均<0.05)。在预测HLAP严重程度的效能比较中,TyG-BMI略低于BISAP评分(Z=−4.368,P<0.001),但优于GLU(Z=2.155,P<0.001),其受试者工作特征曲线下面积为0.891,敏感度为91.10%,特异度为96.80%。结论TyG-BMI对HLAP严重程度具有一定的预测价值,临床上可用于HLAP病情的综合评估。
Objective To investigate the value of triglyceride glucose-body mass index(TyG-BMI)index in predicting the severity of hyperlipidemic acute pancreatitis(HLAP).Methods A retrospective analysis was performed for the clinical data of 185 patients with HLAP who were admitted to Tianyou Hospital Affiliated to Wuhan University of Science and Technology from January 2021 to December 2023,and according to the revised Atlanta classification criteria for acute pancreatitis,they were divided into mild group with 95 patients and moderate or severe group with 90 patients.Clinical features were compared between the two groups to analyze the correlation between TyG-BMI and the severity of HLAP,and the efficacy of TyG-BMI in predicting the severity of HLAP was analyzed.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.Univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for the severity of HLAP.A Spearman correlation analysis was used to investigate the correlation between TyG-BMI and the severity of HLAP,and the receiver operating characteristic(ROC)curve was used to analyze the efficacy of TyG-BMI in predicting the severity of HLAP.Results There were significant differences between the mild group and the moderate or severe group in creatinine,blood glucose(GLU),triglyceride,TyG-BMI,and Bedside Index for Severity in Acute Pancreatitis(BISAP)score(Z=−2.059,−7.217,−7.799,−9.566 and−11.386,all P<0.05).The multivariate Logistic regression analysis showed that BISAP score(odds ratio[OR]=4.221,95%confidence interval[CI]:1.421—12.538,P=0.001),TyG-BMI(OR=1.262,95%CI:1.140—1.396,P=0.010),and GLU(OR=1.316,95%CI:1.040—1.666,P=0.022)were independent risk factors for the severity of HLAP and were positively correlated with the severity of HLAP(r=0.839,0.705,and 0.532,all P<0.05).In the comparison of the efficacy of these indicators in predicting the severity of HLAP,TyG-BMI had a slightly lower efficacy than BISAP score(Z=−4.368,P<0.001)and a significantly better efficacy than GLU(Z=2.155,P<0.001),with an area under the ROC curve of 0.891,a sensitivity of 91.10%,and a specificity of 96.80%.Conclusion TyGBMI index has a certain value in predicting the severity of HLAP and can be used in clinical comprehensive assessment of HLAP.
作者
罗萍萍
刘群
黄丽雯
LUO Pingping;LIU Qun;HUANG Liwen(Department of Gastroenterology,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430064,China;Department of Infectious Diseases,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430064,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2024年第8期1661-1665,共5页
Journal of Clinical Hepatology
基金
湖北省卫生健康委科研项目(WJ2019M257)。
