目的：探讨急性胰腺炎患者疲劳危险因素,并提出干预对策。方法：采用简单随机抽样法,纳入2024年1月—2024年6月本院收治的153例急性胰腺炎患者作为观察对象,根据疲劳严重度量表（fatigue severity scale,FSS）评分将其分为分为非疲劳组（9分<FSS评分<36分）与疲劳组（FSS≥36分）。采用单因素和多因素分析方法分析影响其疲劳发生的危险因素,并构建风险预测模型,通过受试者工作曲线（ROC）分析其预测价值。结果：两组患者的年龄、住院天数及急性生理与慢性健康评分系统Ⅱ（acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ）评分对比,存在统计学差异。疲劳组患者的血清C反应蛋白（C-reactive protein,CRP）、平均血小板体积（mean platelet volume,MPV）及红细胞分布宽度（red cell distribution width,RDW）水平均高于非疲劳组。年龄≥60岁（OR=2.264,95%CI：1.411~3.630）、APACHEⅡ评分较高（OR=2.106,95%CI：1.489~2.980）、血清CRP（OR=2.298,95%CI：1.206~4.379）、MVP（OR=1.756,95%CI：1.180~2.614）、RDW水平偏高（OR=1.917,95%CI：1.564~2.351）及住院时间较长（OR=1.923,95%CI：1.310~2.824）等因素均是影响急性胰腺炎患者发生疲劳的高危因素。本研究所构建的风险预测模型预测急性胰腺炎患者疲劳发生风险的AUC为0.895（0.820~0.969）,敏感度为93.75%,特异度为84.72%。结论：急性胰腺炎患者的疲劳风险与年龄、病情严重性、炎症指标和住院时长等因素有关。本研究构建的风险预测模型能有效预测疲劳风险,具有高敏感性和特异性。医护人员应针对这些因素制定干预措施,减少患者疲劳。
Abstract
Objective To explore the risk factors of fatigue in patients with acute pancreatitis, and put forward intervention countermeasures. Methods 153 patients with acute pancreatitis admitted to our hospital from January 2024 to June 2024 were taken as the observation objects, and they were divided into non-fatigue group (9 points<FSS score<36 points) and fatigue group (FSS score ≥36 points) according to the score of the fatigue severity scale (FSS). The risk factors affecting their fatigue were analyzed by univariate and multivariate analysis methods, and a risk prediction model was established. Results There were statistical differences in age, hospitalization days and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score between the two groups. Serum C-reactive protein (CRP), mean platelet volume (MPV) and red cell distribution width (RDW) levels in fatigue group were higher than those in non-fatigue group. Age ≥60 years old (OR=2.264, 95% CI: 1.411-3.630), high APACHE Ⅱ score (OR=2.106, 95% CI: 1.489-2.980), serum CRP (OR=2.298, 95% CI: 1.200).95% CI: 1.180-2.614), high RDW level (OR=1.917, 95% CI: 1.564-2.351) and long hospital stay (OR=1.923, 95% CI: 1.310-2.824) all affect the fatigue of patients with acute pancreatitis. The risk prediction model constructed in this study predicts the risk of fatigue in patients with acute pancreatitis with AUC of 0.895(0.820-0.969), sensitivity of 93.75% and specificity of 84.72%. Conclusion The fatigue risk of patients with acute pancreatitis is related to age, severity of illness, inflammatory index and length of hospital stay. The risk prediction model constructed in this study can effectively predict fatigue risk with high sensitivity and specificity. Medical staff should formulate intervention measures against these factors to reduce patient fatigue.
关键词
急性胰腺炎 /
疲劳 /
危险因素 /
干预对策
Key words
acute pancreatitis /
fatigue /
risk factors /
intervention countermeasures
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] MEHTA MS.Acute pancreatitis in children: risk factors, management, and outcomes[J]. Curr Opin Pediatr, 2023, 35(5): 590-595.
[2] TRIKUDANATHAN G, YAZICI C, EVANS PHILLIPS A, et al.Diagnosis and Management of Acute Pancreatitis[J]. Gastroenterology, 2024, 167(4): 673-688.
[3] BOSSOLA M, HEDAYATI SS, BRYS ADH, et al.Fatigue in Patients Receiving Maintenance Hemodialysis: A Review[J]. Am J Kidney Dis, 2023, 82(4): 464-480.
[4] 潘泗红, 张振贤, 黄瑶, 等. 慢性疲劳综合征流行病学、病因及病机的研究进展[J]. 临床医学研究与实践, 2024, 9(21): 195-198.
[5] 曹锋, 李非, 赵玉沛. 《中国急性胰腺炎诊治指南(2021)》解读[J]. 中国实用外科杂志, 2021, 41(7): 758-761.
[6] LACZYNSKI DJ, GALLOP J, SICARD GA, et al.Benchmarking a Center of Excellence in Vascular Surgery: Using Acute Physiology and Chronic Health Evaluation II to Validate Outcomes in a Tertiary Care Institute[J]. Vasc Endovascular Surg, 2023, 57(8): 856-862.
[7] 隆艳飞, 李佳, 邓芳慧, 等. 急性胰腺炎患者生活质量与心理状态、社会支持的相关性分析[J]. 湖南师范大学学报(医学版), 2023, 20(03): 135-139.
[8] 张晓敏, 尚福泰. 重症急性胰腺炎继发胰腺感染的危险因素分析及应对[J]. 湖南师范大学学报(医学版), 2020, 17(04): 73-76.
[9] 贾艳红, 王坤, 王册, 等. 老年患者缺血性中风后疲劳现状、相关因素分析及对预后的影响[J]. 中华保健医学杂志, 2024, 26(01): 104-106.
[10] 陈泯竹. 急性胰腺炎患者疲劳现状及影响因素分析[D]. 遵义: 遵义医科大学, 2021.
[11] 周游. 慢性胰腺炎患者疲劳和生活质量相关性研究[D]. 扬州: 扬州大学, 2023.
[12] ZHOU Y, HUANG RQ, XU JJ, et al.Prevalence and risk factors of fatigue and its association with quality of life among patients with chronic pancreatitis: A cross-sectional study[J]. Pancreatology, 2024, 24(2): 211-219.
[13] 孟庆丽, 郭凯. 慢性心力衰竭患者自我调节疲劳现状及其影响因素分析[J]. 实用心脑肺血管病杂志, 2024, 32(7): 26-30.
[14] 杨金盘, 马秋平, 张佳琳, 等. 老年缺血性脑卒中患者急性期发生脑卒中后疲劳的影响因素及风险预测模型[J]. 广西医学, 2024, 46(5): 687-694.
[15] 孟利, 郎延梅.2型糖尿病患者自我调节疲劳现状及影响因素[J]. 护理学杂志, 2023, 38(23): 73-76.
[16] 谷阁, 王润之, 张梦辉, 等. 血清淀粉样蛋白A联合APACHE Ⅱ评分对急性胰腺炎预后的预测价值[J]. 中国急救复苏与灾害医学杂志, 2022, 17(12): 1626-1629.
[17] 范波, 闫润生. DAO、D-LA及APACHE Ⅱ、GCSI-R评分对急性胰腺炎患者病情严重程度及预后的评估价值[J]. 医学临床研究, 2022, 39(10): 1452-1455.
[18] 王增鑫, 董杰. TyG指数、Ca2+、CRP对急性胰腺炎病情严重程度的预测价值研究[J]. 肝胆外科杂志, 2023, 31(5): 364-367.
[19] 刘蕃荔, 洪英, 张宏, 等. CT评分系统联合MPV、RDW对急性胰腺炎患者预后的预测价值[J]. 临床医学研究与实践, 2024, 9(20): 18-21.
[20] 殷将领, 赵茗茗, 王尧, 等. 不同时期重症急性胰腺炎临床特点及疾病转归的影响因素分析[J]. 临床和实验医学杂志, 2024, 23(07): 698-702.
基金
江苏省卫生健康委科研项目 “Treg通过TGF-β通路减轻急性胰腺炎腺泡细胞持续损伤的机制研究”（Z2023013）
PDF(2174 KB)
