术后肾阻力指数对老年髋关节置换术后急性肾损伤的诊断价值

Diagnostic value of postoperative renal resistive index for acute renal injury after hip arthroplasty in elderly patients

目的探讨术后肾阻力指数(RI)对老年髋关节置换术后急性肾损伤(AKI)的诊断价值。方法选取2015年12月-2016年12月该院收住的91例老年髋关节置换术后患者。应用超声测定肾脏叶间动脉RI,根据7 d内是否发生AKI分为非AKI组和AKI组;比较两组RI大小,同时绘制术后RI和血肌酐(Scr)受试者工作特征(ROC)曲线,比较两者曲线下面积。结果纳入研究的91例患者,非AKI组47例,AKI组44例。AKI组术后肾RI值(0.74±0.03)高于非AKI组(0.62±0.04),差异有统计学意义(P<0.05);术后肾RI和Scr对AKI诊断ROC曲线下面积分别为0.955(95%CI:0.912,0.980)、0.778(95%CI:0.681,0.876)。结论老年髋关节置换术后较高的肾RI与AKI发生有关,可作为AKI的诊断指标。

Objective To investigate the diagnostic value of postoperative renal resistive index for acute renal injury after hip arthroplasty in elderly patients. Methods From December 2015 to December 2016, 91 elderly patients after hip arthroplasty were enrolled in the Surgical Intensive Care Unit（SICU）, and the renal arterial resistive index was measured by ultrasonography. All patients were divided into no AKI group and AKI group within 7 days. The value of RI was compared between the two groups. At the same time, the receiver operating characteristic（ROC） curve of RI and serum creatinine（Scr） were drawn, and the area under the curve was compared. Results Among the 91 patients included in the study, 47 were in no AKI group and 44 in AKI group. The postoperative renal RI in AKI group（0.74 ± 0.03） was higher than that in no AKI group（0.62 ± 0.04）, and the difference was statistically significant（P〈0.05）. The area under the ROC curve of AKI was 0.9547（95% CI： 0.912, 0.980） and 0.7783（95% CI： 0.681, 0.876）, respectively. Conclusion The higher value of renal RI in elderly patients after hip arthroplasty was related to AKI, so renal RI can be used as a diagnostic indicator of AKI.