| 徐维,许继元,李茂琴,等.彩色多普勒超声对感染性休克病人肾脏血流动力学及预后评估的价值[J].安徽医药,2024,28(3):581-585. |
| 彩色多普勒超声对感染性休克病人肾脏血流动力学及预后评估的价值 |
| Evaluation value of color Doppler ultrasound for renal hemodynamics and prognosis in patients with septic shock |
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| DOI：10.3969/j.issn.1009-6469.2024.03.034 |
| 中文关键词: 感染性休克 彩色多普勒超声 肾脏血流动力学 肾功能损害 预后 |
| 英文关键词: Septic shock Color Doppler ultrasound Renal hemodynamics Renal dysfunction Prognosis |
| 基金项目:徐州市科技项目( KC22162) |
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| 中文摘要: |
| 目的分析彩色多普勒超声检测感染性休克病人肾脏血流动力学参数及其对预后评估的价值。方法回顾性分析徐州市中心医院 2019年 1月至 2020年 1月收治 120例感染性休克病人病历资料，按病人急性肾损伤( AKI)程度分为无 AKI组(n= 23)、 AKI 1~2期组( n=46)和 AKI 3期组( n=51)对比三组肾血流动力学参数检查结果，分析病人肾血流动力学参数与肾功能损害的关系；依据病人预后情况分为存活组( n=52)，和死亡组( n=68)分析彩色多普勒超声检测肾脏血流动力学参数与病人预后的关系。结果与无 AKI组病人相比， AKI 1~2期组和 AKI 3期组病人，的肾叶间动脉收缩期最大血流速度(PSV)［(34.57±5.01) cm/s、(29.32±4.53)cm/s比( 54.21±7.00)cm/s］和舒张末期血流速度( EDV)［( 12.18±3.01)cm/s、(9.54±2.49)cm/s比( 24.87±3.59) cm/s］显著下降( P<0.05)； PSV和 EDV随 AKI分期增加而显著下降( P<0.05)肾血管阻力指数( RI)随 AKI分期增加而升高( P<0.05)； PSV和 EDV与感染性休克病人的 AKI分期呈负相关， RI与 AKI分期相关。死亡组病人的 EDV(11.06±3.00)cm/s显著低于存活组( 16.65±5.21)cm/s(P<0.05)，RI显著高于存活组( P<0.05)；死亡组病人的基础疾病占比 63.24%、急性生理学和慢性健康状况评价 Ⅱ(APACHEⅡ)(24.87±4.77)分和多器官功能障碍综合征( MODS)评分( 7.12±0.89)分均显著高于存活组呈正， |
| 英文摘要: |
| Objective To analyze and study the evaluation value of color Doppler ultrasound for renal hemodynamics parameters andits prognosis in patients with septic shock.Methods The medical records of 120 patients with septic shock admitted to Xuzhou Cen.tral Hospital from January 2019 to January 2020 were retrospectively analyzed, and the patients were assigned into non-AKI group (n= 23) and AKI stage 1-2 group (n=46) and AKI stage 3 group (n=51) according to the degree of acute kidney injury (AKI). The results ofrenal hemodynamic parameters in the three groups were compared, and the relationship between hemodynamic parameters and renalfunction damage were analyzed. The patients were assigned into a survival group (n=52) and a death group (n=68) according to the prog.nosis, and the relationship between the renal hemodynamic parameters detected by color Doppler ultrasound and the prognosis of thepatients was analyzed.Results Compared with patients in the non-AKI group, the maximum systolic flow velocity (PSV) [(34.57±5.01) cm/s, (29.32±4.53) cm/s vs. (54.21±7.00) cm/s] and end-diastolic flow velocity (EDV) [(12.18±3.01) cm/s, (9.54±2.49) cm/s vs. (24.87±3.59) cm/s] in the interlobar arteries of the kidneys of patients with AKI in stage 1, 2 and 3 group decreased considerably (P<0.05); PSV and EDV decreased markedly (P<0.05) and renal vascular resistance index (RI) increased with increasing AKI stage (P<0.05);PSV and EDV were negatively correlated with AKI stage in patients with infectious shock, and RI was positively correlated with AKIstage. EDV (11.06±3.00) cm/s of death group was significantly lower than that of the surviving group (16.65±5.21) cm/s (P<0.05), and the RI level was dramatically higher than that of the surviving group (P<0.05). The percentage of the underlying disease (63.24%), theacute Physiology and Chronic Health Score (APACHEⅡ) (24.87±4.77) and Multiple Organ Dysfunction Syndrome (MODS) score (7.12±0.89) in death group were notably higher than those in the surviving group (40.38%, 17.21±4.12 and 5.37±0.54) (P<0.05). Underlyingdiseases, APACHEⅡ score, MODS score, EDV and RI were all independent risk factors for the prognosis of patients with septic shock (P<0.05), and variance inflation factor (VIF) values were all lower than 3.Conclusion Color Doppler ultrasound detection of renal he.modynamics in patients with septic shock can reflect the severity of AKI and can be used to evaluate the prognosis of patients. |
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