静脉负荷超声评分对入住ICU的急性心力衰竭患者发生急性肾损伤的预测价值  

Predictive value of venous excess ultrasound score for acute kidney injury in ICU-admitted patients with acute heart failure

作　　者：钟林 汪敏 盛菊萍 沈玲 姜建平 ZHONG Lin;WANG Min;SHENG Juping;SHEN Ling;JIANG Jianping(Department of Critical Care Medicine,the First People's Hospital of Pinghu,Pinghu 314200,China)

机构地区：[1]平湖市第一人民医院重症医学科,314200

出　　处：《浙江医学》2025年第8期839-843,共5页Zhejiang Medical Journal

基　　金：浙江省教育厅一般科研项目(Y202456473);平湖市科技计划项目(社发类13号)。

摘　　要：目的探讨静脉负荷超声(VExUS)评分对入住重症监护病房(ICU)的急性心力衰竭患者发生急性肾损伤(AKI)的预测价值。方法回顾性选取2023年6月至2024年6月平湖市第一人民医院ICU收治的78例急性心力衰竭患者作为研究对象。在入科6 h内完成VExUS评分,根据是否发生AKI将患者分为AKI组33例和非AKI组45例,比较两组患者临床资料,采用多因素logistic回归分析急性心力衰竭患者发生AKI的危险因素,采用ROC曲线评估VExUS评分预测急性心力衰竭患者发生AKI的效能。结果AKI组合并慢性肾功能不全比例高于非AKI组,左心室射血分数低于非AKI组,VExUS评分高于非AKI组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示慢性肾功能不全、VExUS评分升高是急性心力衰竭患者发生AKI的独立危险因素(均P<0.05)。ROC曲线分析显示,VExUS评分预测急性心力衰竭患者发生AKI的AUC为0.838,截断值为2.0分,灵敏度为0.848,特异度为0.778。结论对于入住ICU的急性心力衰竭患者,VExUS评分是预测发生AKI的一个强有力的预测因子。Objective To investigate the predictive value of the venous excess ultrasound(VExUS)score for acute kidney injury(AKI)in patients with acute heart failure admitted to the intensive care unit(ICU).Methods A retrospective study was conducted on 78 patients with acute heart failure admitted to the ICU of The First People's Hospital of Pinghu from June 2023 to June 2024.The VExUS score was assessed within 6 hours of ICU admission.Patients were divided into an AKI group(n=33)and a non-AKI group(n=45)based on AKI occurrence.Clinical data were compared between the two groups.Multivariate logistic regression was used to identify risk factors for AKI,and ROC curves were employed to evaluate the predictive efficacy of the VExUS score.Results Compared to the non-AKI group,the AKI group had a higher proportion of chronic renal insufficiency,lower left ventricular ejection fraction(LVEF),and higher VExUS score(all P<0.05).Multivariate logistic regression analysis identified chronic renal insufficiency and elevated VExUS score as independent risk factors for AKI in patients with acute heart failure(both P<0.05).ROC analysis revealed that the AUC of VExUS score in predicting AKI was 0.838,with a cutoff value of 2.0,sensitivity of 0.848,and specificity of 0.778.Conclusion The VExUS score is a powerful predictor of AKI in ICU-admitted patients with acute heart failure.

关 键 词：静脉负荷超声 急性心力衰竭 急性肾损伤 

分 类 号：R541.6[医药卫生—心血管疾病]