Sevencan Nurhayat Ozkan, Ozkan Aysegul Ertinmaz
The University of Karabuk, Medical Faculty, Department of Internal Medicine, Karabuk, Turkey.
Medicine (Baltimore). 2018 Oct;97(40):e12434. doi: 10.1097/MD.0000000000012434.
The scientific studies that have been conducted so far highlight that renal resistive index (RI) and aortic knob width (AKW) indicate poor prognosis regarding renal and cardiovascular mortality. But the existence of a direct relationship RI and AKW is unclear. This study aims investigating the relationship between RI and the measured AKW in chest radiography of the patients with hypertensive nephropathy who do not require renal replacement therapy.This prospective study included 268 consecutive patients with essential hypertension. Patients were divided into 2 groups as RI ≥0.7 and RI <0.7. The ROC curve, sensitivity, and specificity ratios were evaluated to determine which AKW value is the best predictive one for the RI ≥0.7.The cutoff point of AKW was evaluated as ≥36 for the cases with RI ≥0.7: sensitivity was 71.22%; specificity was 71.32%; the positive predictive value (PPV) was 72.79; the negative predictive value (NPV) was 69.70, and the accuracy was 71.27. Area under the ROC curve ± standard error (AUC ± SE) = 0.729 ± 0.031 (P < .001).AKW can provide important predictive information about the subclinical renal dysfunction in hypertensive patients with RI ≥0.7. Moreover; AKW is a predictive factor for both the diagnostic and prognostic evaluation of renal pathologies.
迄今为止开展的科学研究表明，肾阻力指数（RI）和主动脉结宽度（AKW）提示肾脏和心血管疾病死亡率的预后较差。但RI与AKW之间是否存在直接关系尚不清楚。本研究旨在调查不需要肾脏替代治疗的高血压肾病患者胸部X线检查中RI与测量的AKW之间的关系。这项前瞻性研究纳入了268例连续性原发性高血压患者。患者按RI≥0.7和RI<0.7分为两组。评估ROC曲线、敏感度和特异度比值，以确定哪个AKW值对RI≥0.7具有最佳预测性。对于RI≥0.7的病例，AKW的截断点评估为≥36：敏感度为71.22%；特异度为71.32%；阳性预测值（PPV）为72.79；阴性预测值（NPV）为69.70，准确度为71.27。ROC曲线下面积±标准误（AUC±SE）=0.729±0.031（P<0.001）。AKW可为RI≥0.7的高血压患者亚临床肾功能不全提供重要的预测信息。此外，AKW是肾脏疾病诊断和预后评估的一个预测因素。
