彩色多普勒超声预测急性肾损伤的准确性

Accuracy of color Doppler in predicting acute kidney injury

目的 评价彩色多普勒超声预测急性肾损伤(AKI)的准确性.方法 存在AKI危险因素,未诊断为AKI的患者,年龄≥18岁,性别不限.入选后1 h内通过彩色多普勒超声监测患者肾脏血流(RBF)分级,于叶间动脉或弓状动脉水平监测肾叶间动脉的阻力指数值(RRI值),计算校正值.通过测定血清肌酐及尿量,诊断患者在24 h内AKI的发生情况,绘制受试者工作特征曲线.结果 非AKI组38例,AKI组40例.与非AKI组比较,AKI组患者RBF分级降低,RRI值升高(P<0.05),RRI校正值差异无统计学意义(P>0.05).RBF分级、RRI值预测患者24 h内发生AKI的曲线下面积及其95%可信区间分别为0.659(0.561~0.747)和0.669(0.572~0.756).结论 彩色多普勒超声对患者24 h内发生AKI具有一定的预测价值.

Objective To evaluate the accuracy of color Doppler in predicting acute kidney injury ( AKI) . Methods Patients of both sexes with AKI risk factors not diagnosed with AKI, aged ≥18 yr, were enrolled in this study. Within 1 h after inclusion, the renal blood flow ( RBF) grade was monitored u-sing color Doppler, and renal resistive index ( RRI) value of renal interlobar artery was monitored at the level of renal interlobar or arcuate arteries, and corrected RRI value was calculated. The development of AKI was recorded within 24 h through measuring serum creatinine and urine volume, and the receiver oper-ating characteristic curve was plotted. Results Thirty-eight patients were included in non-AKI group and 40 ones in AKI group. Compared with non-AKI group, RBF grade was significantly decreased, RRI value was increased ( P<0. 05) , and no significant change was found in the corrected RRI value in AKI group ( P>0. 05) . The area under the curve of RBF grade and RRI value in predicting AKI occurred within 24 h and 95% confidence interval were 0. 659 ( 0. 561-0. 747) and 0. 669 ( 0. 572-0. 756) , respectively. Con-clusion Color Doppler has a certain value in predicting AKI within 24 h.