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Objective To investigate the risk factors for acute kidney injury (AKI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI),and to establish a prediction score system for AKI.Methods Totally 296 patients with NSTEMI,who were admitted to the emergency room and further transferred to the Cardiovascular Department in Shantou Central Hospital,were enrolled during January 2011 to April 2014.All patients were divided into AKI group and non-AKI group.Demographics,clinical data and laboratory examinations were collected before and after AKI.AKI risk factors and its OR values were determined after statistically analyzed data by One-Way ANOVA,multivariate logistic regression analysis.Prediction score system for AKI was further established by area under the ROC curve and Hosmer-Lemeshow goodness of fit tests.Results For total 296 patients,the incidence of AKI was 18.4％,including 35 (64.8％) patients in stage Ⅰ,12 (22.2％) patients in stage Ⅱ and 7 (13.0％) patients in stage Ⅲ.Logistic analysis showed that age,heart function (Killip),anemia,the time to emergency department after AMI attack,and absence β-blocker were independent factors associated with AKI.Prediction score system was established which the highest score was 13.A risk score of 3.5 points was determined by Youden' s index,as the optimal cut-off for predict AKI.Patients with ≤3.0 points were considered at low risk,and ≥4.0 points were considered at high risk for AKI.The prediction score system of AKI showed adequate discrimination (area under ROC curve was 0.806) and calibration (Hosmer-Lemeshow statistic test,P =O.503).Conclusions Age,heart function (Killip),anemia,the time to emergency department after AMI attack,and absence β-blocker were independent factors associated with AKI.The clinical prediction score system may help clinicians to make pre-intervention for NSTEMI patients with high AKI risk.
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Objective To study the clinical features of hyperlipidemic acute pancreatitis(HL-AP)and to en-hyance the awareness of diagnosis and treatment of HL-AP. Methods To Retrospective analyse 159 cases with acute pancreatitis (AP), of which 18 cases of HL-AP(HL-AP group), 141 cases of other causes of AP(non-HL-AP group),to compare the age, triglyceride (TG), calcium (Ca2+) levels, blood glucose (GLU), CT severity index (CTSI), acute physiology and chronic health evaluation (APACHE Ⅱ) and the the incidence of combined diabetic ketoacidosis (DKA) in two groups,correlative analysis between TG in HL-AP group and the above-mentioned indicators was car-rird out. Results In addition to significantly decreased Ca22+ , TG, APACHEⅡ score, CTSI points, GLU, and the combined incidence of DKA were significantly increased (both P < 0. 05) in HL-AP group when compared with the control group,TG and APACHE Ⅱ score, CTSI score were positively correlated(P < 0. 05),TG and the Ca2+ was negatively correlated (r = - 0. 795, P < 0. 01). Conclusion HL-AP is not uncommon, mainly patients are young and middle-aged with positively correlated between serum TG levels and the HL-AP lesions, and the condition is more seri-ous and,we should pay attention to the early diagnosis and treatment of HL-AP, main treatment is non-surgical treat-ment.