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多参数超声评估在脓毒症合并急性肾损伤中的诊断价值。

Diagnostic value of multi-parameter ultrasound evaluation in sepsis complicated by acute kidney injury.

机构信息

Department of Ultrasound Medicine, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China.

Department of Critical Care Medicine, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China.

出版信息

Ren Fail. 2024 Dec;46(1):2313861. doi: 10.1080/0886022X.2024.2313861. Epub 2024 Feb 12.

Abstract

BACKGROUND

This study aimed to discuss the diagnostic value of multi-parameter ultrasound evaluation in sepsis complicated with acute kidney injury (AKI).

METHODS

Patients were divided into an AKI group ( = 50) and a non-injury group ( = 50) based on the presence of AKI. The clinical characteristics were collected, and renal function parameters between the two groups were compared, including 24-h urine volume, serum creatinine, urea, serum cystatin C (CysC), renal parenchymal thickness (RPT), renal artery resistance index (RI), and multi-parameter ultrasound scoring (MPUS). Additionally, logistic regression analysis was conducted to determine the influencing factors of sepsis complicated with AKI. The prediction value was evaluated using a receiver operating characteristic (ROC) curve.

RESULTS

In the AKI group, creatinine, CysC, urea, MPUS score, RPT, and RI values were significantly higher, while the 24-h urine volume was lower than those in the non-injury group ( < 0.01). Moreover, multivariate logistic analysis indicated that high CysC and RI values were independent risk factors, whereas high 24-h urine volume and low MPUS were independent protective factors for sepsis-induced AKI. The ROC curve demonstrated that RI (AUC = 0.906) was more effective than 24-h urine volume (AUC = 0.797), CysC (AUC = 0.730), and MPUS (AUC = 0.794) in identifying sepsis-induced AKI.

CONCLUSION

High RI values increase the risk of sepsis-induced AKI, whereas low MPUS may reduce it. RI showed high diagnosis values for sepsis complicated with AKI.

摘要

背景

本研究旨在探讨多参数超声评估在脓毒症合并急性肾损伤(AKI)中的诊断价值。

方法

根据是否存在 AKI,患者被分为 AKI 组(n=50)和非损伤组(n=50)。收集临床特征,比较两组肾功能参数,包括 24 小时尿量、血清肌酐、尿素、血清胱抑素 C(CysC)、肾实质厚度(RPT)、肾动脉阻力指数(RI)和多参数超声评分(MPUS)。此外,采用逻辑回归分析确定脓毒症合并 AKI 的影响因素。使用受试者工作特征(ROC)曲线评估预测价值。

结果

在 AKI 组,肌酐、CysC、尿素、MPUS 评分、RPT 和 RI 值显著升高,而 24 小时尿量低于非损伤组(P<0.01)。此外,多因素逻辑回归分析表明,高 CysC 和 RI 值是独立的危险因素,而高 24 小时尿量和低 MPUS 是脓毒症导致 AKI 的独立保护因素。ROC 曲线表明,RI(AUC=0.906)比 24 小时尿量(AUC=0.797)、CysC(AUC=0.730)和 MPUS(AUC=0.794)更有效地识别脓毒症导致的 AKI。

结论

高 RI 值增加了脓毒症引起 AKI 的风险,而低 MPUS 可能降低了风险。RI 对脓毒症合并 AKI 具有较高的诊断价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fe/10863507/17e57f86c856/IRNF_A_2313861_F0001_C.jpg

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