床旁超声监测与BUN、D-D对脓毒症患儿肾脏损伤的诊断分析  

Diagnosis Analysis of Renal Injury in Children with Sepsis by Bedside Ultrasonography, BUN and D-D

作　　者：郭晓理[1] 唐爱华[1] 施惠[1] 朱艳 GUO Xiaoli;TANG Aihua;SHI Hui;ZHU Yan(Department of Pediatrics,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu,P.R.China)

机构地区：[1]南通大学附属医院儿科,江苏南通226001

出　　处：《影像科学与光化学》2022年第5期1317-1321,共5页Imaging Science and Photochemistry

摘　　要：本文目的是探究床旁超声监测与血尿素氮(BUN)、D-二聚体(D-D)的相关性及对脓毒症患儿肾脏损伤的诊断分析。选取60例疑似脓毒症合并肾脏损伤患儿为研究对象,将其分为肾脏损伤(40例)和非肾脏损伤(20例),根据24 h尿白蛋白排泄率水平分轻度肾脏损伤组(n=22)、中度肾脏损伤组(n=18),所有患儿均行床旁超声监测及BUN、D-D水平测定。与非肾脏损伤组相比,肾脏损伤组下腔静脉吸气塌陷率较低,下腔静脉内径、心室舒张末期内径(LVIDd)水平较高(P<0.05);与轻度肾脏损伤患儿相比,中度肾脏损伤患儿下腔静脉吸气塌陷率较低,下腔静脉内径、LVIDd水平较高(P<0.05);与轻度肾脏损伤患儿相比,中度肾脏损伤患儿BUN、D-D水平升高(P<0.05);下腔静脉内径、LVIDd均与BUN、D-D水平呈正相关,下腔静脉吸气塌陷率与BUN、D-D水平呈负相关(P<0.05);床旁超声联合BUN、D-D监测联合诊断脓毒症合并肾脏损伤的ROC曲线下面积(AUC)高于单一检测(P<0.05)。床旁超声联合BUN、D-D监测可提高脓毒症患儿肾脏损伤的诊断准确性和灵敏性。This paper aimed to explore the correlation between bedside ultrasonography, blood urea nitrogen(BUN) and D-dimer(D-D) in the diagnosis analysis of renal injury in children with sepsis. 60 children with suspected sepsis complicated with renal injury were selected as the research objects, and they were divided into renal injury(40 cases) and non-renal injury(20 cases). According to the level of 24 h urinary albumin excretion rate the renal injury group were divided into the severe renal injury group(n=22) and the moderate renal injury group(n=18). All children underwent bedside ultrasonography, BUN and D-D levels test. Compared with the non-kidney injury group, the inspiratory collapse rate of the inferior vena cava in the renal injury group were decreased, and the inner diameter of the inferior vena cava and the ventricular end-diastolic diameter(LVIDd) were higher(P<0.05). Compared with patients with mild renal injury, the inspiratory collapse rate of the inferior vena cava were lower in patients with moderate renal injury, and the inner diameter of the inferior vena cava and the level of LVIDd were higher(P<0.05). Compared with the children in the mild renal injury group, the BUN and D-D levels of the children in the moderate renal injury group were increased(P<0.05).The inner diameter of the inferior vena cava and LVIDd were positively correlated with the BUN and D-D levels.The inspiratory collapse rate of the inferior vena cava was negatively correlated with the levels of BUN and D-D(P<0.05).The area under the ROC curve(AUC)of bedside ultrasound combined with BUN and D-D monitoring in the diagnosis of sepsis complicated with renal injury were higher than those of single detection(P<0.05).Bedside ultrasound combined with BUN and D-D monitoring can improve the diagnostic accuracy and sensitivity of renal injury in children with sepsis.

关 键 词：床旁超声 血尿素氮 D-二聚体 脓毒症 肾脏损伤 诊断价值 

分 类 号：R720.597[医药卫生—急诊医学]