基于实验室指标模型的脓毒症急性肾损伤的早期预测分析  

Early Prediction Analysis of Sepsis-associated Acute Kidney Injury Based on Laboratory Index Model

作　　者：李娜 林廷芳 卢迎 贺兴华 李军 王波 LI Na;LIN Ting-fang;LU Ying;HE Xing-hua;LI Jun;WANG Bo(Pingkuang General Hospital,Pingxiang Jiangxi 337000,China)

机构地区：[1]萍乡矿业集团有限责任公司医院,江西萍乡337000

出　　处：《抗感染药学》2023年第3期281-285,共5页Anti-infection Pharmacy

基　　金：江西省卫生健康委科技计划(编号:202212083)。

摘　　要：目的:分析基于降钙素原(procalcitonin,PCT)、肾动脉阻力指数(renal resistance index,RRI)、L选择素(CD62L)等实验室指标早期预测脓毒症急性肾损伤(sepsis-associated acute kidney injury,SA-AKI)的能力,为脓毒症患者急性肾损伤的早发现、早诊断、早治疗提供参考。方法:选取2020年8月—2022年5月医院收治的80例脓毒症患者作为研究对象,根据是否发生SA-AKI将患者分为发生组(n=30)和未发生组(n=50);收集患者的一般资料和CD62L、PCT、RRI水平,建立模型,分析CD62L、PCT与RRI联合检测对SA-AKI的早期预测能力。结果:发生组患者的PCT、CD62L和RRI均高于未发生组(P<0.05);PCT、CD62L、RRI联合检测预测SA-AKI的曲线下面积(area under the curve,AUC)值(0.992)高于单一预测的AUC值(0.882、0.943、0.911);且联合检测灵敏度、特异度、约登指数均高于单一检测。结论:基于PCT、CD62L、RRI等指标可较为准确地预测SA-AKI是否发生,且综合3种指标可以更准确地预知SA-AKI,从而有利于SA-AKI患者的成功救治。Objective:To analyze the early prediction ability of sepsis-associated acute kidney injury(SA-AKI)based on laboratory indexes such as procalcitonin(PCT),renal resistance index(RRI),and L selectin(CD62L),so as to provide reference for early detection,early diagnosis and early treatment of patients suffering from SA-AKI.Methods:A total of 80 sepsis patients admitted to the hospital from August 2020 to May 2022 were selected as the research objects.The patients were divided into the occurrence group(n=30)and the non-occurrence group(n=50)based on whether SA-AKI occurred.General information of patients and levels of CD62L,PCT and RRI were collected,and a model was established to analyze the early prediction ability of combined detection of CD62L,PCT and RRI for SA-AKI.Results:The levels of PCT,CD62L and RRI of patients in the occurrence group were higher than those in the non-occurrence group(P<0.05).The area under the curve(AUC)value(0.992)of SA-AKI predicted by the combined detection of PCT,CD62L and RRI was higher than the AUC value(0.882,0.943,0.911)of single prediction.The sensitivity,specificity and Youden index of combined detection were higher than those of single detection.Conclusion:The occurrence of SA-AKI can be predicted more accurately based on indexes such as PCT,CD62L and RRI,and SA-AKI can be foreseen more accurately by combining the three indexes,which is beneficial to successful treatment and cure of patients with SA-AKI.

关 键 词：脓毒症 急性肾损伤 早期预测 降钙素原 肾动脉阻力指数 L选择素 

分 类 号：R181.32[医药卫生—流行病学]