血尿素氮/白蛋白比值在预测急性胰腺炎患者不良临床结局中的作用

The Role of the BUN/Albumin Ratio in Predicting Poor Clinical Outcomes in Patients with Acute Pancreatitis.

作者信息

Biyik Z, Biyik M, Yavuz Y C, Altintepe L, Korez M K, Cizmecioglu A

机构信息

Department of Internal Medicine, Division of Nephrology, Selcuk University Faculty of Medicine, Konya, Turkey.

Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.

出版信息

Niger J Clin Pract. 2025 Mar 1;28(3):360-366. doi: 10.4103/njcp.njcp_528_24. Epub 2025 Apr 11.

DOI:10.4103/njcp.njcp_528_24

PMID:40214063

Abstract

BACKGROUND

The blood urea nitrogen (BUN) to albumin ratio (BAR) has emerged as a potential prognostic marker in various pathological states.

AIM

This study aims to elucidate the utility of BAR in predicting the incidence of acute kidney injury (AKI) and severe acute pancreatitis (SAP) in patients diagnosed with acute pancreatitis (AP).

METHODS

This retrospective analysis included 210 patients diagnosed with AP and monitored at a tertiary university hospital. Patients were classified into three categories based on the severity of pancreatitis: mild AP, moderately severe AP, and severe AP.

RESULTS

BAR levels increased significantly with the progression of disease severity (P < 0.001). Median BAR values were 3.3 for mild AP, 3.9 for moderately severe AP, and 11.6 for severe AP. In multivariate regression analysis, BAR was identified as an independent prognostic factor for both severe AP (odds ratio [OR] =1.341, 95% confidence interval [CI]: 1.016-1.612, P = 0.002) and AKI (OR = 1.382, 95% CI: 1.138-1.679, P = 0.001). Receiver operating characteristic (ROC) analysis indicated that a BAR threshold exceeding 5.192 predicted severe AP with a sensitivity (Sn) of 71.4% and specificity (Sp) of 82.5% (area under the curve [AUC] =0.849, P < 0.001). Additionally, a BAR threshold greater than 4.505 was found to predict AKI with a Sn of 63.2% and Sp of 86.6% (AUC = 0.782, P < 0.001).

CONCLUSION

BAR, assessed at hospital admission, demonstrates considerable promise as a readily accessible biomarker for predicting the severity of AP and the development of AKI.

摘要

背景

血尿素氮（BUN）与白蛋白比值（BAR）已成为多种病理状态下潜在的预后标志物。

目的

本研究旨在阐明BAR在预测急性胰腺炎（AP）患者急性肾损伤（AKI）和重症急性胰腺炎（SAP）发生率方面的作用。

方法

这项回顾性分析纳入了210例在一所三级大学医院接受监测的AP确诊患者。根据胰腺炎的严重程度将患者分为三类：轻度AP、中度重症AP和重症AP。

结果

BAR水平随疾病严重程度的进展显著升高（P<0.001）。轻度AP的BAR中位数为3.3，中度重症AP为3.9，重症AP为11.6。在多因素回归分析中，BAR被确定为重症AP（比值比[OR]=1.341，95%置信区间[CI]：1.016-1.612，P=0.002）和AKI（OR=1.382，95%CI：1.138-1.679，P=0.001）的独立预后因素。受试者工作特征（ROC）分析表明，BAR阈值超过5.192时预测重症AP的灵敏度（Sn）为71.4%，特异度（Sp）为82.5%（曲线下面积[AUC]=0.849，P<0.001）。此外，发现BAR阈值大于4.505时预测AKI的Sn为63.2%，Sp为86.6%（AUC=0.782，P<0.001）。