超声监测RBF分级RRI联合BUA/Scr比值对重症腹腔感染患者发生急性肾损伤的预警价值

doi:10.3969/j.issn.1006-6233.2025.07.022

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摘要 目的: 探讨超声监测肾脏血流(RBF)分级、肾脏阻力指数(RRI)联合血尿酸(BUA)/血肌酐(Scr)比值对重症腹腔感染患者发生急性肾损伤(AKI)的预警价值。方法: 选取2021年6月至2023年6月重症腹腔感染患者180例,根据入院7d内是否发生AKI分为AKI组与无AKI组。比较两组基线资料、RBF分级、RRI、BUA/Scr比值,分析RBF分级、RRI、BUA/Scr比值对AKI的预警价值,另选取2023年7月至2024年7月重症腹腔感染患者96例作为外部验证数据集,验证RBF分级、RRI联合BUA/Scr比值对AKI的预警价值。结果: 两组脓毒症、感染性休克、器官功能衰竭系统(SOFA)评分、急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ)比较,差异有统计学意义(P<0.05);AKI组与无AKI组RBF分级、RRI、BUA/Scr比值比较,差异有统计学意义(P<0.05);RBF分级与BUA/Scr比值呈负相关,RRI与BUA/Scr比值呈正相关(P<0.05);RBF分级、RRI、BUA/Scr比值与AKI显著相关(P<0.05);RBF分级、RRI联合BUA/Scr比值预警AKI的AUC为0.901,优于三者单独预测价值(P<0.05);RBF分级、RRI联合BUA/Scr比值预警外部验证数据集中重症腹腔感染患者发生AKI的AUC为0.928。结论: RBF分级、RRI、BUA/Scr比值与重症腹腔感染患者AKI存在一定关系,三者联合在评估患者发生AKI具有较高预警价值。

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关键词 ：肾脏血流分级, 肾脏阻力指数, 血尿酸, 血肌酐, 急性肾损伤

Abstract：Objective: To investigate the predictive value of ultrasonographic monitoring of renal blood flow (RBF) grading, renal resistance index (RRI) combined with blood uric acid (BUA)/serum creatinine (Scr) ratio for early warning of acute kidney injury (AKI) in patients with severe intra-abdominal infection. Methods: A total of 180 patients with severe intra-abdominal infection admitted from June 2021 to June 2023 were enrolled, and divided into AKI group and non-AKI group according to whether AKI occurred within 7 days of admission. Baseline data, RBF grading, RRI, and BUA/Scr ratio were compared between the two groups. The predictive value of RBF grading, RRI, and BUA/Scr ratio for AKI was analyzed. Additionally, 96 patients with severe intra-abdominal infection admitted from July 2023 to July 2024 were selected as an external validation dataset to verify the predictive value of RBF grading, RRI combined with BUA/Scr ratio for AKI. Results: There were statistically significant differences in the sepsis, septic shock, and organ failure assessment (SOFA) scores, as well as the acute physiology and chronic health evaluation II (APACHE II) scores between the two groups (P<0.05). There were significant differences in RBF grading, RRI, and BUA/Scr ratio between the AKI group and the non-AKI group (P<0.05). RBF grading was negatively correlated with the BUA/Scr ratio, while RRI was positively correlated with the BUA/Scr ratio (P<0.05). RBF grading, RRI, and BUA/Scr ratio were significantly correlated with AKI (P<0.05). The AUC of RBF grading and RRI combined with BUA/Scr ratio for predicting AKI was 0.901, which was superior to the predictive value of the three alone (P<0.05). The AUC of AKI in severe abdominal infection patients in the external validation dataset for RBF grading, RRI combined with BUA/Scr ratio early prediction was 0.928. Conclusion: RBF grading, RRI, and BUA/Scr ratio are associated with AKI in patients with severe intra-abdominal infection. The combination of these three indices has a high predictive value for evaluating the occurrence of AKI.

Key words： Renal blood flow grading Renal resistance index Blood uric acid Blood creatinine Acute kidney injury

基金资助:安徽省卫生健康委员会科研重点项目,(编号:AHWJ2022a026)

通讯作者: 顾国胜

引用本文:

王见斌, 孟令胜, 杨威, 黎雨, 赵前扬, 顾国胜. 超声监测RBF分级RRI联合BUA/Scr比值对重症腹腔感染患者发生急性肾损伤的预警价值[J]. 河北医学, 2025, 31(7): 1176-1181.
WANG Jianbin, MENG Lingsheng, YANG Wei, et al. Predictive Value of Ultrasonographic Monitoring of Renal Blood Flow Grading Renal Resistance Index Combined with Blood Uric Acid /Serum Creatinine Ratio for Early Warning of Acute Kidney Injury in Patients with Severe Intra-abdominal Infection. HeBei Med, 2025, 31(7): 1176-1181.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.07.022 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I7/1176

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