全血细胞计数衍生的炎症指标对急性A型主动脉夹层患者术后发生急性肾损伤的预测价值
Predictive Value of the Complete Blood Counts Derived Inflammatory Indexes for Postoperative Acute Kidney Injury in Patients with Acute Type A Aortic Dissection
摘要: 目的：评估全血细胞计数衍生的炎症指标对急性A型主动脉夹层(ATAAD)患者手术后急性肾损伤(AKI)的预测价值。方法：本研究收集了2021年8月至2024年8月间在青岛大学附属医院接受手术治疗的ATAAD患者的临床资料。通过多因素逻辑回归模型探索术后发生AKI的独立危险因素并构建联合预测因子，采用受试者工作特征曲线(ROC)和曲线下面积(AUC)分析这些危险因素对术后AKI的预测价值。结果：共251例患者被纳入分析，术后AKI的发生率为51.8%。多因素逻辑回归分析显示术前中性粒细胞与淋巴细胞比值(NLR)，以及术后1小时内的NLR、全身免疫炎症指数(SII)、全身炎症综合指数(AISI)是ATAAD患者手术后发生AKI的独立危险因素。其中术前NLR对术后发生AKI的预测价值最高(AUC = 0.7011; OR, 1.337; 95% CI: 1.021~1.750)，联合预测因子对术后AKI的预测效果优于单项指标(AUC = 0.7845; OR, 1.671; 95% CI: 1.446~1.930)。结论：术前NLR、术后1小时内NLR、SII和AISI等全血细胞计数衍生的炎症指标可用于对术后AKI进行早期预测。
Abstract: Objective: To investigate the predictive value of the Complete Blood Counts (CBC) derived inflammatory indexes for postoperative acute kidney injury (AKI) in patients with Acute Type A Aortic Dissection (ATAAD). Methods: The clinical data of all patients who underwent ATAAD surgery in the Affiliated Hospital of Qingdao University from August 2021 to August 2024 were included. Multivariate logistic regression was used to identify the independent risk factors for postoperative AKI. Receiver Operating Characteristic curve (ROC) and Area under Curve (AUC) were used to analyze the predictive value of these independent risk factors for postoperative AKI. Results: A total of 251 patients were included in the analysis, with a postoperative incidence rate of AKI of 51.8%. Multivariate logistic regression analysis showed that the preoperative Neutrophil-to-Lymphocyte Ratio (NLR), as well as the NLR, Systemic Immune-Inflammation Index (SII), and Aggregate Index of Systemic Inflammation (AISI) within 1 hour after surgery, were independent risk factors for the development of AKI after surgery in patients with ATAAD. Among these, the preoperative NLR had the highest predictive value for postoperative AKI (AUC = 0.7011; OR, 1.337; 95% CI: 1.021~1.750). The combined predictive factors showed better predictive performance for postoperative AKI than individual indicators (AUC = 0.7845; OR, 1.671; 95% CI: 1.446~1.930). Conclusion: Preoperative NLR, as well as NLR, SII, and AISI within 1 hour after surgery, which are derived from complete blood cell counts, can be used for early prediction of postoperative AKI.
文章引用：刘丹, 李宗笑. 全血细胞计数衍生的炎症指标对急性A型主动脉夹层患者术后发生急性肾损伤的预测价值[J]. 临床医学进展, 2025, 15(7): 816-826. https://doi.org/10.12677/acm.2025.1572059

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