Page 122 - 《南京医科大学学报（自然科学版）》2025年第9期

南京医科大学学报（自然科学版） 第45卷第9期
·1334 · Journal of Nanjing Medical University（Natural Sciences） 2025年9月

·临床研究·

重症监护病房急性胰腺炎患者入科首日血清白蛋白与院内死

亡风险的相关性研究

黄东亚，侯超群，葛万里，彭云鹏，蒋奎荣，李 强 *

南京医科大学第一附属医院胰腺中心，江苏 南京 210029

［摘 要］ 目的：探讨重症监护病房（intensive care unit，ICU）急性胰腺炎（acute pancreatitis，AP）患者入科首日血清白蛋白
（albumin，ALB）水平与院内死亡风险的关联及其潜在的非线性关系。方法：回顾性分析了MIMIC⁃IV数据库中2008—2019年
首次入住ICU的728例成年AP患者数据。提取患者入ICU首日ALB水平及相关临床资料，采用多因素Logistic回归模型评估
ALB 与院内死亡风险的线性关系，并通过广义加性模型（generalized additive model，GAM）和两分段线性回归模型探索非线性
关系及拐点。结果：在调整多个混杂因素后，入 ICU 首日 ALB 水平每升高 1 g/L，患者院内死亡风险降低 27%（OR=0.73，95%
CI：0.59~0.92，P=0.007）。GAM分析进一步揭示ALB与院内死亡风险之间存在显著的非线性关系，拐点为28 g/L。当ALB≤28 g/L
时，ALB每升高1 g/L，院内死亡风险显著降低56%（OR=0.44，95% CI：0.26~0.73，P=0.001）；而当ALB > 28 g/L时，此关联无统计
学意义。结论：AP患者入ICU首日血清ALB水平与院内死亡风险呈显著的非线性负相关，28 g/L是识别高风险患者的一个重
要临床拐点。早期监测并关注ALB水平对AP患者的风险分层和临床决策具有重要意义。
［关键词］ 急性胰腺炎；血清白蛋白；院内病死率；重症监护病房
［中图分类号］ R576 ［文献标志码］ A ［文章编号］ 1007⁃4368（2025）09⁃1334⁃08
doi： 10.7655/NYDXBNSN250579

A study on the correlation between first ⁃ day serum albumin on ICU admission and in ⁃
hospital mortality risk in patients with acute pancreatitis
HUANG Dongya，HOU Chaoqun，GE Wanli，PENG Yunpeng，JIANG Kuirong，LI Qiang *
Department of Pancreas Center，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective： To investigate the association between first⁃day serum albumin（ALB）levels upon intensive care unit（ICU）
admission and in⁃hospital mortality in patients with acute pancreatitis（AP），and to explore its potential non⁃linear nature. Methods：
This retrospective study analyzed data from 728 adult AP patients admitted to the ICU for the first time from2008 to 2019，sourced from
the MIMIC⁃IV database. First⁃day ICU ALB levels and relevant clinical data were extracted. Multivariate logistic regression models
were used to assess the linear relationshipbetween ALB and in ⁃ hospital mortality. Generalized additive models（GAM）and two ⁃
piecewise linear regression models were employed to explore non⁃linear relationships and identify inflection points. Results：After
adjusting for multiple confounders，each 1 g/L increase in first⁃day ICU ALB was associated with a 27% reduction in in⁃hospital
mortality risk（OR=0.73，95% CI：0.59-0.92，P=0.007）. GAM analysis further revealed a significant non⁃linear relationship between
ALB and in⁃hospital mortality，with an inflection point at 28 g/L. When ALB was≤28 g/L，each 1 g/L increase in ALBwas associated
with a 56% significant reduction in mortality risk（OR=0.44，95%CI：0.26-0.73，P=0.001）；however，no statistical significance was
observed when ALB > 28 g/L. Conclusion：First⁃day ICU serum ALB levels in patients with AP demonstrated a significant non⁃linear
negative association with in ⁃ hospital mortality. An ALB level of 28 g/L was identified as an important clinical inflection point for
distinguishing high⁃risk patients. Early monitoring and attention to ALB levels are crucial for risk stratification and clinical decision⁃
making in AP patients.
［Key words］ acute pancreatitis；serum albumin；in⁃hospital mortality；intensive care unit
［J Nanjing Med Univ，2025，45（09）：1334⁃1341］
［基金项目］ 南京医科大学第一附属医院（江苏省人民医院）“临床能力提升工程”面上项目（JSPH⁃MB⁃2021⁃2）
通信作者（Corresponding author），E⁃mail： liqiang020202@163.com（ORCID：0000⁃0001⁃5129⁃2603）
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