Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
Br J Hosp Med (Lond). 2024 Aug 30;85(8):1-11. doi: 10.12968/hmed.2024.0283.
Bedside ultrasound evaluation of venous excess ultrasound (VExUS) combined with the triglyceride-glucose (TyG) index plays an important role in predicting acute kidney injury (AKI) in patients with acute hyperlipidemic pancreatitis. VExUS can effectively evaluate the degree of venous congestion, while the TyG index is valuable in predicting severe pancreatitis. The combination of these two methods is expected to provide a more accurate AKI risk assessment tool for clinical practice. This study explores the value of combining bedside ultrasound evaluation using the VExUS grading system with the TyG index in predicting acute renal damage in patients with acute hyperlipidemic pancreatitis. From January 2021 to December 2023, 110 patients with acute hyperlipidemic pancreatitis were selected. The patients were divided into two groups based on whether they were complicated with acute kidney injury (AKI): the AKI group (n = 23) and the non-AKI group (n = 87). The general data of the two groups were compared, and the risk factors for AKI in patients with acute hyperlipidemic pancreatitis were analyzed using multivariate logistic regression. The predictive value was assessed using receiver operating characteristic curve (ROC) analysis. There were no statistically significant differences in age, gender, outcome, triglyceride (TG), total cholesterol, low-density lipoprotein (LDL) levels at admission, blood nutrition at discharge, creatinine (CREA) at discharge, underlying diseases, start time of enteral nutrition, complications, length of stay, Intensive Care Unit (ICU) days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood glucose level, blood amylase level, CREA, blood urine nitrogen (BUN), blood purification treatment ( > 0.05). However, there were significant differences ( < 0.05) between the TyG index and the VExUS score, with variables including the TyG index and the VExUS score (included in the logistic regression analysis as variables), and AKI (AKI = 1, non-AKI = 0) as dependent variables. Multiple logistic regression results showed that the TyG index and VExUS score were independent predictors of AKI in patients with acute hyperlipidemia pancreatitis ( < 0.05). The standard error, sensitivity and specificity of the TyG index, VExUS score and combined model for predicting AKI in these patients were 0.064, 73.91 and 87.45; 0.036, 78.16 and 95.65; 0.010, 100.00 and 95.65, respectively ( < 0.05). The VExUS score combined with the TyG index is highly valuable in predicting AKI in patients with acute hyperlipidemic pancreatitis.
床边超声评估静脉淤血超声（VExUS）联合甘油三酯-葡萄糖（TyG）指数在预测急性高脂血症性胰腺炎患者急性肾损伤（AKI）方面具有重要作用。VExUS 可有效评估静脉淤血程度，而 TyG 指数在预测重症胰腺炎方面具有价值。这两种方法的结合有望为临床实践提供更准确的 AKI 风险评估工具。本研究探讨了床边超声评估使用 VExUS 分级系统与 TyG 指数相结合在预测急性高脂血症性胰腺炎患者急性肾损伤中的价值。
2021 年 1 月至 2023 年 12 月，选择 110 例急性高脂血症性胰腺炎患者。根据是否合并急性肾损伤（AKI）将患者分为 AKI 组（n=23）和非 AKI 组（n=87）。比较两组一般资料，采用多因素 logistic 回归分析急性高脂血症性胰腺炎患者 AKI 的危险因素。采用受试者工作特征曲线（ROC）分析评估预测价值。
两组患者的年龄、性别、结局、入院时甘油三酯（TG）、总胆固醇、低密度脂蛋白（LDL）水平、出院时血液营养状况、出院时肌酐（CREA）、基础疾病、肠内营养开始时间、并发症、住院时间、重症监护病房（ICU）天数、急性生理和慢性健康评估 II（APACHE II）评分、血糖水平、血淀粉酶水平、CREA、血尿素氮（BUN）、血液净化治疗等差异无统计学意义（>0.05）。然而，TyG 指数和 VExUS 评分存在显著差异（<0.05），包括 TyG 指数和 VExUS 评分（作为变量包含在逻辑回归分析中），以及 AKI（AKI=1，非 AKI=0）作为因变量。多因素逻辑回归结果显示，TyG 指数和 VExUS 评分是急性高脂血症性胰腺炎患者 AKI 的独立预测因子（<0.05）。TyG 指数、VExUS 评分和联合模型预测这些患者 AKI 的标准误、敏感性和特异性分别为 0.064、73.91 和 87.45；0.036、78.16 和 95.65；0.010、100.00 和 95.65（<0.05）。
综上所述，VExUS 评分联合 TyG 指数对预测急性高脂血症性胰腺炎患者 AKI 具有较高的价值。
