彩色多普勒超声用于重症感染急性肾损伤的诊断价值

发布时间：2018-08-28 18:39

【摘要】：目的探讨彩色多普勒超声用于重症感染急性肾损伤的诊断价值,为重症感染急性肾损伤的诊断提供参考。方法选取2013年1月-2016年12月在医院内住院诊断重症感染患者60例,所有患者在入院第1天时行彩色多普勒超声检查,将检查结果与确诊结果进行对照分析。结果 60例患者在入院第1天时42例确诊有急性肾损伤,发生率为70.00%,45例感染性休克患者中36例发生急性肾损伤、15例脓毒症患者中6例发生急性肾损伤,急性肾损伤发生率分别为80.00%、40.00%,不同感染疾病类型患者急性肾损伤发生率比较差异有统计学意义(P0.05);肺部感染、腹腔感染、其他部位感染患者急性肾损伤发生率分别为68.75%、71.43%、71.43%,不同原发感染部位患者急性肾损伤发生率比较差异无统计学意义;在入院第1天时有36例患者彩色多普勒超声检查存在急性肾损伤,彩色多普勒超声用于重症感染患者急性肾损伤诊断的敏感度为76.19%、特异度为77.78%、阳性预测值为88.89%、诊断符合率为76.67%;急性肾损伤与无急性肾损伤的重症感染患者肾长径、肾横径、肾实质厚度比较差异无统计学意义,急性肾损伤患者肾叶间动脉阻力指数(RI)与搏动指数(PI)分别为0.71±0.09、1.38±0.07,高于无急性肾损伤患者0.65±0.06、1.33±0.05,比较差异有统计学意义(P0.05)。结论重症感染患者容易发生急性肾损伤,急性肾损伤患者在彩色多普勒超声下可表现肾叶间动脉RI与PI升高,彩色多普勒超声用于重症感染急性肾损伤的诊断有一定临床价值。
[Abstract]:Objective to evaluate the diagnostic value of color Doppler ultrasound in the diagnosis of acute renal injury caused by severe infection. Methods 60 patients with severe infection were selected from January 2013 to December 2016. All the patients were examined by color Doppler ultrasound on the first day of admission. The results were compared with the results of diagnosis. Results on the first day of admission, 42 patients with acute renal injury were diagnosed. The incidence of acute renal injury was 70.005 / 45. Of the 45 patients with septic shock, 36 had acute renal injury and 6 of 15 sepsis patients had acute renal injury. The incidence of acute renal injury was 80.004 000. The incidence of acute renal injury in patients with different types of infectious diseases was significantly different (P0.05). The incidence of acute renal injury in patients with other sites of infection was 68.75, 71.43 and 71.43, respectively. There was no significant difference in the incidence of acute renal injury in patients with different primary infection sites. On the first day of admission, 36 patients with acute renal injury were examined by color Doppler ultrasound. The sensitivity, specificity and positive predictive value of color Doppler ultrasound in the diagnosis of acute renal injury in patients with severe infection were 76.19, 77.78 and 88.89, respectively. There was no significant difference in the thickness of renal parenchyma. The resistance index (RI) and pulsatile index (PI) of renal interlobar artery in patients with acute renal injury were 0.71 卤0.09 卤1.38 卤0.07, respectively, which were significantly higher than those in patients without acute renal injury (P 0.05). Conclusion Acute renal injury is easy to occur in patients with severe infection. RI and PI of renal interlobar artery can be increased in patients with acute renal injury under color Doppler ultrasound. Color Doppler ultrasound has some clinical value in the diagnosis of acute renal injury caused by severe infection.
【作者单位】：海南省第三人民医院功能科;
【基金】：三亚市医疗卫生科技创新项目基金资助项目(2015YW33)
【分类号】：R445.1;R692.5

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