静脉超声分级系统对多发性创伤患者住院并发急性肾损伤的预测价值  

Predictive value of venous excess ultrasound grading system in acute kidney injury of hospitalized patients with multiple trauma

作　　者：江苏梅 陈媛媛 阙献琴 Jiang Sumei;Chen Yuanyuan;Que Xianqin(Emergency Department,Lishui Central Hospital,Lishui 323000,China)

机构地区：[1]丽水市中心医院急诊医学科,浙江丽水323000

出　　处：《中国急救医学》2024年第9期760-764,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨静脉负荷超声(VExUS)分级系统对多发性创伤患者住院并发急性肾损伤(AKI)的预测价值。方法选取2020年11月至2023年12月丽水市中心医院收治的162例多发性创伤患者为研究对象,根据其住院期间是否发生AKI,分为AKI组(n=61)和未AKI组(n=101)。收集患者的临床资料和VExUS得分,采用Logistic回归分析探讨AKI的危险因素,绘制受试者工作特征(ROC)曲线分析VExUS评分的预测价值。同时选取2024年1月至2024年3月期间本院另外收治的符合纳入与排除标准的35例多发性创伤并发AKI患者为验证对象,绘制ROC曲线验证VExUS评分预测多发性创伤患者并发AKI的价值。结果多因素Logistic回归分析结果显示,血清肌酐(SCr)、降钙素原(PCT)、胱抑素C(Cys-C)、C反应蛋白(CRP)、VExUS评分是多发性创伤患者并发AKI的危险因素(P<0.05)。ROC曲线分析结果显示,SCr、PCT、Cys-C、CRP、VExUS评分预测多发性创伤患者并发AKI的曲线下面积(AUC)分别为0.636(95%CI 0.516~0.758,P=0.023)、0.742(95%CI 0.633~0.850,P<0.001)、0.628(95%CI 0.521~0.735,P=0.022)、0.705(95%CI 0.601~0.808,P=0.001)、0.793(95%CI 0.715~0.871,P<0.001),其中VExUS评分预测的ROC最高,最佳截断值为2分,敏感度为81.97%,特异度为61.66%。加以验证的ROC曲线结果显示,VExUS评分对多发性创伤患者并发AKI仍具有良好预测价值,AUC为0.740(95%CI 0.648~0.831)。结论VExUS评分对于多发性创伤患者发生AKI具有良好预测价值。Objective To investigate the predictive value of venous excess ultrasound(VExUS)grading system in acute kidney injury(AKI)of hospitalized patients with multiple trauma.Methods A total of 162 patients with multiple trauma admitted to Lishui Central Hospital from November 2020 to December 2023 were selected as the research objects.According to whether AKI occurred during hospitalization,they were divided into AKI group(n=61)and non-AKI group(n=101).The clinical data and VExUS scores were collected.Logistic regression analysis was used to explore the risk factors of AKI,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of VExUS score.At the same time,35 patients with multiple trauma complicated with AKI who met the inclusion and exclusion criteria in Lishui Central Hospital from January to March 2024 were selected as the verification objects,and the ROC curve was drawn to verify the value of VExUS score in predicting AKI in the patients with multiple trauma.Results Multivariate Logistic regression analysis showed that serum creatinine(SCr),procalcitonin(PCT),Cystatin C(Cys-C),C-reactive protein(CRP)and VExUS score were risk factors for AKI in the patients with multiple trauma(P<0.05).The results of ROC curve analysis showed that the areas under ROC curve(AUC)of SCr,PCT,Cys-C,CRP and VExUS scores in predicting AKI in the patients with multiple trauma were 0.636(95%CI 0.516-0.758,P=0.023),0.742(95%CI 0.633-0.850,P<0.001),0.628(95%CI 0.521-0.735,P=0.022),0.705(95%CI 0.601-0.808,P=0.001)and 0.793(95%CI 0.715-0.871,P<0.001),respectively.Among them,the predicted ROC of VExUS score was the highest,and the optimal cut-off value was 2 points.At this time,the sensitivity was 81.97%and the specificity was 61.66%.The results of the validated ROC curve showed that the VExUS score still had a good predictive value for AKI in the patients with multiple trauma,and the AUC was 0.740(95%CI 0.648-0.831).Conclusion The VExUS score has a good predictive value for AKI in the patients with multi

关 键 词：多发性创伤 急性肾损伤 静脉负荷超声分级系统 危险因素 预测价值 

分 类 号：R641[医药卫生—外科学] R692[医药卫生—临床医学]