彩色多普勒超声联合肾功能检查对重症医院感染患者急性肾损伤的诊断价值  

Diagnostic value of color Doppler ultrasonography combined with renal function test in acute renal injury in patients with critical nosocomial infections

作　　者：邹洪庆 王勇[2] 陈新伟[2] 李军[2] 郝慧芳[3] ZOU Hong-qing;WANG Yong;CHEN Xin-wei;LI Jun;HAO Hui-fang(Tianjin United Family Hospital,Tianjin 300221,China)

机构地区：[1]天津市和睦家医院影像科,天津300221 [2]天津市泰达医院检验科,天津300457 [3]天津市泰达医院肾内科,天津300457

出　　处：《中华医院感染学杂志》2018年第19期2914-2916,2920,共4页Chinese Journal of Nosocomiology

基　　金：天津市卫生局科技基金资助项目(2014KY11)

摘　　要：目的探究彩色多普勒超声联合肾功能检查对重症医院感染患者急性肾损伤的诊断价值。方法选择2014年6月-2016年6月医院收治的76例重症医院感染患者为研究对象。所有患者均联合彩色多普勒超声及肾功能检查,将判断急性肾损伤结果与确诊结果对比,判断该方法的诊断效能。结果 76例重症医院感染患者中,行血培养共培养分离病原菌94株,其中革兰阳性菌30株占31.91%,革兰阴性菌57株占60.64%,真菌7株占7.45%。共确诊51例急性肾损伤,且不同感染类型患者发生急性肾损伤率分别为呼吸系统72.50%(29/40)、消化系统66.67%(14/21)、泌尿系统62.50%(5/8)、其他42.86%(3/7),差异无统计学意义(P=0.827);彩色多普勒超声联合肾功能检查共发现30例急性肾损伤,阳性预测值为90.00%、敏感度为77.14%、特异度为81.25%。急性肾损伤患者肾横径、肾长径及肾实质厚度与无急性肾损伤患者差异无统计学意义,但肾叶间动脉PI及肾叶间动脉RI分别为(1.39±0.06)及(0.72±0.08)高于无急性肾损伤者(P<0.001)。结论重症医院感染患者以革兰阴性菌感染多见,且易伴发急性肾损伤。联合彩色多普勒超声及肾功能检查有助于早期发现重症医院感染合并急性肾损伤,具有较好的诊断价值。OBJECTIVE To explore diagnostic value of color Doppler ultrasonography combined with renal function test in acute renal injury in patients with critical nosocomial infections.METHODS 76 patients admitted with critical nosocomial infections from Jun.2014 to Jun.2016 were selected as subjects.All patients were examined by color Doppler ultrasonography combined with renal function tests,and the results of acute renal injury were compared with the diagnosis results,to judge the diagnostic effectiveness of this method.RESULTS Among 76 patients with severe nosocomial infections,94 strains of pathogens were isolated from blood culture.Among them,30 strains of gram-positive bacteria accounted for 31.91%,57 strains of gram-negative bacteria accounted for 60.64%,and 7 strains of fungi accounted for 7.45%.51 cases of acute renal injury were confirmed,and the incidence of acute renal injury in infection of respiratory system was 72.50%（29/40）,and the acute renal injury incidences in infection of digestive system,urinary system and other types of infection were 66.67%（14/21）,62.50%（5/8）,and 42.86%（3/7）,respectively.The difference was not significant（P=0.827）.30 cases of acute renal injury were found by color Doppler ultrasonography combined with renal function examination,the positive predictive value was 90.00%,the sensitivity was 77.14%and the specificity was 81.25%.No significant difference was found in kidney diameter,kidney diameter and renal parenchyma thickness between patients with or without acute renal injury.But the interlobular arterial PI and interlobular artery RI of patients with critical nosocomial infections combined with acute renal injury were（1.39±0.06）and（0.72±0.08）,respectively,which were significantly higher than those without acute renal injury（P〈0.001）.CONCLUSIONPatients with critical nosocomial infections is more common with gram-negative bacteria infection and easily associated with acute renal injury.Combined color Doppler ultrasonography and renal function tests

关 键 词：彩色多普勒超声 肾功能 重症医院感染 急性肾损伤 诊断价值 

分 类 号：R692[医药卫生—泌尿科学]