实用临床医药杂志2026，Vol.30Issue(8)：74-78,84,6.DOI:10.7619/jcmp.20260651
超声血流动力学参数联合肾功能指标对肾移植术后急性肾损伤的预测价值
Predictive value of ultrasonic hemodynamic parameters combined with renal function indicators for acute kidney injury after renal transplantation
摘要
Abstract
Objective To explore the influencing factors and early predictive value of acute kid-ney injury(AKI)after renal transplantation based on ultrasonic hemodynamic parameters and renal function indicators.Methods The clinical data of 166 patients with chronic renal insufficiency at the uremic stage who underwent renal transplantation were retrospectively analyzed.According to whether AKI occurred within 3 months after the operation,the patients were divided into AKI group(61 cases)and non-AKI group(105 cases).The clinical data of the two groups were compared.Multivariate Logis-tic regression analysis was used to screen the influencing factors of AKI after renal transplantation,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy.Results On the first day after the operation,the peak systolic velocity(PSV),end-diastolicvelocity(EDV),resistance index(RI),and pulsatility index(PI)of the renal artery and interlobar artery,the EDV,RI,and PI of the renal segmental artery,and the levels of renal function indicators such as neutrophil gelatinase-associated lipocalin(NGAL),cystatin C(Cys-C),serum creatinine(SCr),blood urea nitrogen(BUN),and β2-microglobulin(β2-MG)in the AKI group showed significant difference from those in the non-AKI group(P＜0.05).Multivariate Logistic regression analysis showed that the renal artery PI(OR=2.249,95％CI,1.346 to 3.757),interlobar artery RI(OR=1.898,95％CI,1.131 to 3.187),NGAL(OR=3.519,95％CI,1.905 to 6.500),Cys-C(OR=2.130,95％CI,1.229 to 3.690),and SCr(OR=2.576,95％CI,1.498 to 4.429)were independent influencing factors for AKI after renal transplantation(P＜0.05).The ROC curve showed that the areas under the curve(AUCs)of the renal artery PI,interlobar artery RI,NGAL,Cys-C,and SCr were 0.722,0.696,0.746,0.711,and 0.761,respectively,with cutoff values of 1.42,0.74,677.63 ng/mL,3.40 mg/L,and 697.38 μmol/L,respectively.The AUC of the combined prediction of the above indicators was 0.905,with a sensitivity of 93.5％and a specificity of 90.2％.The predictive effi-cacy was better than that of each indicator alone.Conclusion The renal artery PI,interlobar artery RI,NGAL,Cys-C,and SCr are independent influencing factors for the occurrence of AKI after re-nal transplantation.The combined prediction model constructed based on these factors has good pre-dictive efficacy for AKI after renal transplantation.关键词
肾移植/急性肾损伤/超声检查/血流动力学参数/胱抑素C/肌酐/中性粒细胞明胶酶相关脂质运载蛋白/移植物功能延迟恢复Key words
renal transplantation/acute kidney injury/ultrasonography/hemodynamic parame-ters/cystatin C/creatinine/neutrophil gelatinase-associated lipocalin/delayed graft function分类
医药卫生引用本文复制引用
李鑫,刘致中,李雪..超声血流动力学参数联合肾功能指标对肾移植术后急性肾损伤的预测价值[J].实用临床医药杂志,2026,30(8):74-78,84,6.基金项目
2024年度中国金属学会冶金安全与健康分会健康卫生科研项目(jkws202417) （jkws202417）
