摘要
目的:探讨肾脏血流动力学超声监测对急性肾损伤(acute kidney injury,AKI)的预测价值。方法:采用回顾性分析方法,选取2022年8月-2023年6月入住无锡市第五人民医院重症医学科的90例AKI患者及30例肾功能正常患者为研究对象,根据AKI程度分为肾功能正常对照组(30例)、AKI 1期组(38例)、AKI 2期组(32例)和AKI 3期组(20例)。记录患者的一般临床资料,同时记录入科时肾脏阻力指数(renal resistive index,RRI)、能量多普勒超声(power doppler ultrasound,PDU)评分。比较各组RRI和PDU评分。将AKI患者分为短暂性AKI组(51例)和持续性AKI组(39例),比较两组RRI和PDU评分。采用ROC曲线分析RRI和PDU评分对AKI的预测能力。结果:AKI 1~3期组的RRI高于正常对照组,差异有统计学意义(P<0.05);AKI 3期组RRI高于AKI 1、2期组,差异有统计学意义(P<0.05);AKI 1期组和正常对照组PDU评分比较差异无统计学意义(P>0.05),AKI 2期组和AKI 3期组PDU评分小于正常对照组和AKI 1期组,AKI 3期组PDU评分小于AKI 2期组,差异有统计学意义(P<0.05);持续性AKI组RRI高于及PDU评分低于短暂性AKI组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,RRI(AUC=0.724,P<0.01)和PDU评分(AUC=0.917,P<0.01)均可预测AKI的发生,PDU评分对AKI的预测效能要好于RRI(P<0.05)。结论:肾脏血流动力学超声早期监测指标RRI和PDU评分对预测AKI的发生具有重要价值。
Objective:To explore the predictive value of renal hemodynamic ultrasound monitoring for acute kidney injury(AKI).Methods:A retrospective analysis method was used.90AKI patients and 30patients with normal renal function were enrolled in this study who were admitted to the Intensive Care Unit of Wuxi Fifth People's Hospital from August 2022to June 2023.According to the degree of AKI,they were divided into a normal renal function control group(30cases),an AKI stage 1group(38cases),an AKI stage 2group(32cases),and an AKI stage 3group(20cases).Their general clinical data were recorded,and simultaneously the renal resistance index(RRI)and power Doppler ultrasound(PDU)scores were recorded at admission.The RRI and PDU scores of each group were compared.AKI patients were divided into transient AKI group(51cases)and persistent AKI group(39cases),and the RRI and PDU scores were compared between the two groups.The predictive ability of RRI and PDU scores on AKI was analyzed using ROC curves.Results:The RRI of AKI stage 1-3group was higher than that of the normal control group,with a statistically significant difference(P<0.05);The RRI of AKI stage 3group was higher than that of AKI stage 1and stage 2groups,with a statistically significant difference(P<0.05);There was no difference in PDU scores between the AKI stage 1group and the normal control group(P>0.05).The PDU scores of the AKI stage 2and AKI stage 3groups were lower than those of the normal control group and AKI stage 1group,and the PDU scores of the AKI stage 3group were lower than those of the AKI stage 2group,with a statistically significant difference(P<0.05);The RRI in the persistent AKI group was higher and the PDU score was lower than that in the transient AKI group,with statistical significance(P<0.05);The ROC curve analysis results showed that both RRI(AUC=0.724,P<0.01)and PDU score(AUC=0.917,P<0.01)can predict the occurrence of AKI,and PDU score has a better predictive effect on AKI than RRI(P<0.05).Conclusion:Early monitoring indicators of renal hemodynam
作者
郭茂松
王群文
尹路
GUO Maosong;WANG Qunwen;YIN Lu(Department of Critical Care Medicine,Wuxi Fifth People's Hospital,Wuxi,Jiangsu,214000,China;Department of Emergency Medicine,Peking University,Shenzhen Hospital)
出处
《临床急诊杂志》
CAS
2023年第9期454-459,共6页
Journal of Clinical Emergency
基金
睿E(睿意)急诊医学研究专项基金资助项目(No:R2021005)。
关键词
肾脏超声
急性肾损伤
肾血流动力学
renal ultrasound
acute kidney injury
renal hemodynamics
