[1]盛海龙,方长太,查佳安.超声造影对重症急性胰腺炎并发早期急性肾损的诊断价值[J].医学信息,2022,35(09):171-174.[doi:10.3969/j.issn.1006-1959.2022.09.044]
　SHENG Hai-long,FANG Chang-tai,ZHA Jia-an.Diagnostic Value of Contrast-enhanced Ultrasonography in Severe Acute Pancreatitis Complicated with Early Acute Kidney Injury[J].Medical Information,2022,35(09):171-174.[doi:10.3969/j.issn.1006-1959.2022.09.044]
点击复制

超声造影对重症急性胰腺炎并发早期急性肾损的诊断价值()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年09期
页码:
171-174
栏目:
诊疗技术
出版日期:
2022-05-01

文章信息/Info

Title:
Diagnostic Value of Contrast-enhanced Ultrasonography in Severe Acute Pancreatitis Complicated with Early Acute Kidney Injury
文章编号:
1006-1959（2022）09-0171-04
作者:
盛海龙; 方长太; 查佳安
（安徽医科大学附属安庆市立医院急诊科1，重症医学科2，安徽 安庆 246000）
Author(s):
SHENG Hai-long; FANG Chang-tai; ZHA Jia-an
(Department of Emergency1,Department of Critical Medicine2,Anqing Municipal Hospital Affiliated to Anhui Medical University,Anqing 246000,Anhui,China)
关键词:
超声造影; 重症急性胰腺炎; 急性肾损伤; 肾皮质; 血流灌注
Keywords:
Contrast-enhanced ultrasonography; Severe acute pancreatitis; Acute kidney injury; Renal cortex; Blood perfusion
分类号:
R692.5
DOI:
10.3969/j.issn.1006-1959.2022.09.044
文献标志码:
A
摘要:
目的 探讨超声造影对重症急性胰腺炎（SAP）并发早期急性肾损的诊断价值。方法 选取2019年12月-2021年6月安庆市立医院重症医学科收治的71例SAP患者作为研究对象，所有患者入院24 h内完成肾脏超声造影、肾功能指标（血肌酐、尿素氮、肌酐清除率）测定，然后根据KDIGO-AKI诊断标准将患者分成肾功能损伤（A1）组27例及非肾功能损伤（N1）组44例，比较两组超声造影参数（PI、TTP、AUC），连续7天监测患者肾功能，第7天再次根据AKI诊断标准将N1组患者分为肾功能损伤（A2）组15例及非肾功能损伤（N2）组29例，比较两组入院24 h内留取的肾脏造影参数与肾功能（血肌酐、尿素氮、肌酐清除率）指标。结果 A1组PI、AUC小于N1组，TTP大于N1组，差异有统计学意义（P＜0.05）；A2与N2组PI、TTP、AUC比较，差异均有统计学意义（P＜0.05）；两组血肌酐、尿素氮、肌酐清除率比较，差异无统计学意义（P＞0.05）。结论 肾脏超声造影在SAP性AKI的诊断中具有重要的预测价值；尤其在AKI早期，其造影参数变化早于实验室指标，通过造影参数定量分析急性肾损伤时肾实质血流灌注情况，在SAP并发AKI早期即可进行诊断。
Abstract:
Objective To investigate the diagnostic value of contrast-enhanced ultrasonography in severe acute pancreatitis complicated with early acute kidney injury.Methods Seventy-one patients with SAP admitted to the Department of Critical Care Medicine of Anqing Municipal Hospital from December 2019 to June 2021 were selected as subjects. All patients underwent renal contrast-enhanced ultrasound and renal function indexes (serum creatinine, urea nitrogen and creatinine clearance rate) were measured within 24 hours of admission. According to KDIGO-AKI diagnostic criteria, the patients were divided into renal function injury (A1) group (n=27) and non-renal function injury (N1) group (n=44). The contrast-enhanced ultrasound parameters (PI, TTP, AUC) were compared between the two groups, and the renal function of the patients was monitored for 7 days. On the 7th day, patients in the N1 group were again divided into renal function injury (A2) group (15 cases) and non-renal function injury (N2) group (29 cases) according to the AKI diagnostic criteria, and the renal angiography parameters and renal function (serum creatinine, urea nitrogen, creatinine clearance rate) indexes were compared between the two groups within 24 h after admission.Results PI and AUC of group A1 were lower than those of group N1, and TTP was higher than that of group N1, the difference was statistically significant(P<0.05). PI and AUC of group A1 were lower than those of group N1, and TTP was higher than that of group N1, the difference was statistically significant (P<0.05). There was no significant difference in serum creatinine, urea nitrogen and creatinine clearance rate between the two groups (P>0.05).Conclusion Renal contrast-enhanced ultrasonography has important predictive value in the diagnosis of SAP AKI. Especially in the early stage of AKI, the changes of contrast parameters are earlier than the laboratory indexes. Quantitative analysis of renal parenchymal blood perfusion in acute renal injury by contrast parameters can be used for early diagnosis of SAP complicated with AKI.

参考文献/References:

[1]Devani K,Charilaou P,Radadiya D,et al.Acute pancreatitis:Trends in outcomes and the role of acute kidney injury in mortality-A propensity-matched analysis[J].Pancreatology,2018(18):870-877.[2]朱青云,孙运波,潘新亭,等.CRRT联合超声引导下经皮经肝胆囊穿刺置管引流在治疗重症急性胆源性胰腺炎中的临床评价[J].中华急诊医学杂志,2017,26(6):669-673.[3]Wang L,Mohan C.Contrast-enhanced ultrasound:A promising method for renal microvascular perfusion evaluation[J].J Transl Int Med,2016,4(3):104-108.[4]罗旭颖,周建新,席修明.急性肾损伤的诊断：肌酐还是尿量？[J].中华重症医学电子杂志,2017,3(1):9-13.[5]李华,高月花,贾化平,等.急性肾损伤肾脏超声造影的初步临床研究[J].中国超声医学杂志,2017,33(6):533-536.[6]王俊义,高心晶,王东,等.动态超声造影对脓毒症性AKI的诊断性研究[J].中华危重病急救医学,2018,30(2):160-164.[7]任嘉铭,冷振鹏,杨敬春,等.超声造影定量分析技术在慢性肾脏病早期的应用价值[J].中国医药导报,2020,16(17):143-146,155.[8]雒大健,宋建军,罗兵,等.超声造影检测结石梗阻性肾病伴肾周积水患者肾脏血流动力学变化的临床价值[J].中国医学前沿杂志 (电子版),2018,10(1):53-56.[9]Khwaja A.KDIGO clinical practice guidelines for acute kidney injury[J].Nephron Clin Pract,2012,120(4):179-184.[10]姜春晖,曾彦博,杜奕奇.外泌体在重症急性胰腺炎发病机制中的作用[J].中华胰腺病杂志,2019,19(3):231-235.[11]贺贝贝.不同海拔下大鼠重症急性胰腺炎相关肾损伤与IL-10变化的研究[D].青海:青海大学,2016.[12]毕礼明,陈英兰,陈亚峰,等.对重症急性胰腺炎相关AKI发病机制的认识[J].临床肾病杂志,2019,19(7):539-543.[13]王逸平,刘向新,崔晓莉,等.重症急性胰腺炎并发急性肾损伤临床特征及危险因素分析[J].交通医学,2017,31(5):473-476.[14]Nassar TI,Qunibi WY.AKI associated with acute pancreatitis[J].Clin J Am Soc Nephrol,2019,14(7):1106-1115.[15]王洪亮,刘瑞金,于凯江.急性肾损伤诊断标准的变迁如何影响其临床治疗?[J].中华重症医学电子杂志,2017,3(1):5-8.[16]李平华,宋倩,黄连铭.血清肌酐、胱抑素C、NGAL检测对妊娠相关急性肾损伤诊断及预后评估的价值[J].中国计划生育学杂志,2017,25(5):308-313[17]Zhang J,Han J,Liu J,et al.Clinical significance of novel biomarker NGAL in early diagnosis of acute renal injury[J].Exp Ther Med,2017,14(5):5017-5021.[18]王红伟,王高锋,陈言伟.尿NGAL、L-FABP、KIM-1检测在儿童AKI诊断中的临床价值分析[J].实验与检验医学,2021,39(1):154-157.[19]陈雨晴,蒋鑫,徐欢,等.血清胱抑素C对急性胰腺炎并发急性肾损伤的预测价值[J].临床肝胆病杂志,2020,36(11):2505-2508.[20]年亚文,胡金玲.尿Netrin-1及IL-18对脓毒症急性肾损伤早期诊断的临床价值[J].黑龙江医药科学,2018,41(3):96-98.[21]Hall JA,Fritsch DA,Yerramilli M,et al.A longitudinal study on the acceptance and effects of a therapeutic renal food in pet dogs with IRIS-Stage 1 chronic kidney disease[J].J Anim Physiol Anim Nutr(Berl),2018,102(1):297-307.[22]梁媛,梁蕾,郭君,等.实时超声造影定量分析各参数对慢性肾病早期诊断的敏感性分析[J].中华临床医师杂志(电子版),2016,10(11):1532-1535.[23]Yang WQ,Mou S,Xu Y,et al.Quantitative parameters of contrastenhanced ultrasonography for assessment of renal pathology:A preliminary study in chronic kidney disease[J].Clin Hemorheol Microcirc,2018,68(1):71-82.[24]Li Y,You J.The research and application advances of medicalimaging techniques in early renal function assessment of chronic kidney disease[J].Journal of Biomedical Engineering,2019,36(3):511-514.[25]曾祯,胡经纬,李璇,等.超声造影定量分析重度失血性休克再灌注模型大鼠复苏期的肾血流灌注[J].中国组织工程研究,2021,25(8):1201-1206.[26]钟秋红,林栩.超声造影技术在慢性肾脏病中的应用现况[J].右江医学,2017,45(2):247-249.

相似文献/References:

[1]车鹏博,阮继刚,郭 丹.红细胞分布宽度联合D-二聚体含量预测 急性胰腺炎严重程度的价值[J].医学信息,2018,31(12):73.[doi:10.3969/j.issn.1006-1959.2018.12.022]
　CHE Peng-bo,RUAN Ji-gang,GUO Dan.The Value of Red Blood Cell Distribution Width Combined with D-dimer Content in Predicting the Severity of Acute Pancreatitis[J].Medical Information,2018,31(09):73.[doi:10.3969/j.issn.1006-1959.2018.12.022]
[2]只茂叶.重症急性胰腺炎的发病机制与内镜治疗研究[J].医学信息,2022,35(11):68.[doi:10.3969/j.issn.1006-1959.2022.11.019]
　ZHI Mao-ye.The Pathogenesis and Endoscopic Treatment of Severe Acute Pancreatitis[J].Medical Information,2022,35(09):68.[doi:10.3969/j.issn.1006-1959.2022.11.019]
[3]杨 雍,吕汝琦,刘 丹.早期无创正压通气对重症急性胰腺炎合并肺损伤的保护作用机制[J].医学信息,2019,32(03):55.[doi:10.3969/j.issn.1006-1959.2019.03.018]
　YANG Yong,LV Ru-qi,LIU Dan.Protective Mechanism of Early Noninvasive Positive Pressure Ventilation on Severe Acute Pancreatitis Complicated with Lung Injury[J].Medical Information,2019,32(09):55.[doi:10.3969/j.issn.1006-1959.2019.03.018]
[4]刘 云,于洪波.乌司他丁与生长抑素治疗重症急性胰腺炎临床疗效观察[J].医学信息,2019,32(01):160.[doi:10.3969/j.issn.1006-1959.2019.01.050]
　LIU Yun,YU Hong-bo.Clinical Efficacy of Ulinastatin and Somatostatin in the Treatment of Severe Acute Pancreatitis[J].Medical Information,2019,32(09):160.[doi:10.3969/j.issn.1006-1959.2019.01.050]
[5]李 贺,付 锐,孙远松,等.早期区域动脉灌注肝素治疗高脂血症性SAP的临床效果[J].医学信息,2019,32(10):99.[doi:10.3969/j.issn.1006-1959.2019.10.031]
　LI He,FU Rui,SUN Yuan-song,et al.Clinical Effect of Early Regional Arterial Infusion of Heparin inthe Treatment of SAP with Hyperlipidemia[J].Medical Information,2019,32(09):99.[doi:10.3969/j.issn.1006-1959.2019.10.031]
[6]李前进,马惠斌,拜合提亚·阿扎提,等.超声造影与增强CT对小肾癌诊断价值及不同病理类型超声造影表现的研究[J].医学信息,2019,32(10):163.[doi:10.3969/j.issn.1006-1959.2019.10.054]
　LI Qian-jin,MA Hui-bin,Baihe Azati,et al.The Value of Contrast-enhanced Ultrasonography and Contrast-enhanced CT inthe Diagnosis of Small Renal Cell Carcinoma and the Contrast-enhanced Ultrasonography[J].Medical Information,2019,32(09):163.[doi:10.3969/j.issn.1006-1959.2019.10.054]
[7]杜鑫荣.超声造影在肝实质性肿块诊断及鉴别中的临床价值[J].医学信息,2019,32(19):176.[doi:10.3969/j.issn.1006-1959.2019.19.059]
　DU Xin-rong.Clinical Value of Contrast-enhanced Ultrasonography in the Diagnosis and Differential Diagnosis of Liver Mass[J].Medical Information,2019,32(09):176.[doi:10.3969/j.issn.1006-1959.2019.19.059]
[8]陈智华.赤芍加清胰汤联合空肠营养治疗重症急性胰腺炎的临床效果[J].医学信息,2019,32(21):156.[doi:10.3969/j.issn.1006-1959.2019.21.052]
　CHEN Zhi-hua.Clinical Observation on Treatment of Severe Acute Pancreatitis with Chishao Plus Qingyi Decoction Combined with Jejunal Nutrition[J].Medical Information,2019,32(09):156.[doi:10.3969/j.issn.1006-1959.2019.21.052]
[9]董 建,褚志强,童 瑾.超声造影在经皮肝穿射频消融治疗小肝癌中的应用价值[J].医学信息,2020,33(15):174.[doi:10.3969/j.issn.1006-1959.2020.15.056]
　DONG Jian,CHU Zhi-qiang,TONG Jin.Application Value of Contrast-enhanced Ultrasound in PercutaneousRadiofrequency Ablation for Small Liver Cancer[J].Medical Information,2020,33(09):174.[doi:10.3969/j.issn.1006-1959.2020.15.056]
[10]冯维静,许程飞.零缺陷护理干预在连续性血液净化治疗重症急性胰腺炎中的应用[J].医学信息,2021,34(08):186.[doi:10.3969/j.issn.1006-1959.2021.08.052]
　FENG Wei-jing,XU Cheng-fei.Application of Zero Defect Nursing Intervention in Continuous Blood Purification Treatment of Severe Acute Pancreatitis[J].Medical Information,2021,34(09):186.[doi:10.3969/j.issn.1006-1959.2021.08.052]

更新日期/Last Update: 1900-01-01