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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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

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

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