分子影像学杂志2025，Vol.48Issue(12)：1555-1562,8.DOI:10.12122/j.issn.1674-4500.2025.12.14
动态超声肾脏灌注指标可预测脓毒症早期急性肾损伤
Dynamic renal perfusion ultrasound parameters can predict early acute kidney injury in sepsis
摘要
Abstract
Objective To investigate the value of renal resistive index(RRI)and power Doppler ultrasound(PDU)score in predicting sepsis-associated acute kidney injury(SA-AKI)in ICU patients and to analyze their correlations with infection and inflammatory markers.Methods A total of 70 sepsis patients admitted to the Department of Critical Care Medicine,The Second People's Hospital of Foshan from April to December 2023 were included.General clinical data,vital signs at ICU admission,Acute Physiology and Chronic Health Evaluation II(APACHE-II)score,and ultrasonic renal perfusion indices including RRI and PDU score were recorded.Venous blood samples were collected to measure renal function markers as serum creatinine(SCr),blood urea nitrogen(BUN),infection marker as procalcitonin(PCT),and inflammatory marker as interleukin-6(IL-6).Patients were classified into two cohorts:Based on the severest degree of AKI within 48 h,they were divided into a normal renal function control group,AKI stage 1,stage 2,and stage 3 groups;According to renal function recovery within 3 days,they were categorized into transient AKI and persistent AKI groups.Early indices were retrospectively reviewed,and inter-group differences were compared.ROC curves were used to assess the predictive efficacy of RRI and PDU score for AKI,while correlations between PCT,IL-6 and RRI,PDU score were analyzed.Results Among the 70 patients,17 patients were in the non-AKI control group,19 patients in AKI stage 1,15 patients in AKI stage 2,and 19 patients in AKI stage 3.Patients with AKI stage 2 and 3 had significantly higher RRI(P<0.001)and lower PDU score(P<0.001)compared with those in the non-AKI group or AKI stage 1.Additionally,patients in the persistent AKI group had a significantly higher RRI(P<0.001)and a significantly lower PDU(P<0.001)compared with those in the transient AKI group.ROC curve analysis demonstrated that both RRI and PDU score were reliable predictors of AKI.Additionally,PCT and IL-6 levels were significantly elevated in patients with AKI stage 2 and 3,and were significantly correlated with RRI and PDU score.Conclusion Ultrasonic renal perfusion indices as RRI and PDU score hold significant value in predicting AKI development in sepsis patients.They are correlated with infection and inflammatory markers,providing a non-invasive,dynamic imaging approach for the early identification of high-risk patients in clinical practice.关键词
脓毒症/脓毒症相关急性肾损伤/肾动脉阻力指数/能量多普勒评分Key words
sepsis/sepsis-associated acute kidney injury/renal resistive index/power Doppler ultrasound score引用本文复制引用
袁满涓,沈家航..动态超声肾脏灌注指标可预测脓毒症早期急性肾损伤[J].分子影像学杂志,2025,48(12):1555-1562,8.基金项目
佛山市科技局科研课题(2220001004578) （2220001004578）
