摘要
目的探究右心超声指标联合肾血流多普勒评分(RVDS)评估终末期肾病(ESRD)患者透析间期是否需再次透析的价值。方法根据是否需再次接受透析治疗,将46例符合ESRD诊断且处于透析间期患者分为需透析组及对照组,使用超声监测右心指标,并记录双侧肾脏RVDS。使用受试者工作特征曲线评价各参数诊断效能,并将RVDS与肾小球滤过率、肌酐指标进行相关性分析。结果需透析组较对照组具有较高的右心室内径(RVD)、三尖瓣最大反流速度、肺动脉收缩压、室间隔偏心指数,和较低的三尖瓣环收缩期位移(TAPSE)、三尖瓣环收缩期最大速度(S’)、R-RVDS和L-RVDS(P均<0.05)。RVD、室间隔偏心指数、TAPSE、S’、三尖瓣最大反流速度、肺动脉收缩压、R-RVDS预测ESRD患者再次少尿的AUC值分别为0.765、0.750、0.770、0.780、0.707、0.723、0.682。TAPSE联合R-RVDS的敏感度92.0%,特异度76.2%,AUC值0.850。相关性分析显示,R-RVDS和L-RVDS分别与肾小球滤过率呈正相关性(r值分别为0.514和0.544);R-RVDS和L-RVDS分别与肌酐呈负相关性(r值分别为-0.337和-0.484)。结论右心超声指标联合RVDS对ESRD患者需再次透析者具有较好的评估和预测价值。
Objective To explore the value of right heart ultrasound index combined with renal vascular doppler score(RVDS)in evaluating the need for re-dialysis in patients with end-stage renal disease(ESRD).Methods According to the need for re-dialysis,46 patients diagnosed as ESRD during dialysis were divided into the dialysis and control groups.Right heart ultrasound index was recorded by bedside ultrasonography,and the RVDS of bilateral kidneys was recorded.Receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of each parameter.The correlation of RVDS with glomerular filtration rate and creatinine was analyzed.Results Compared with the control group,ESRD patients in the dialysis group had significantly higher right ventricular diameter(RVD),maximum tricuspid regurgitation velocity,pulmonary arterial systolic pressure,interventricular septal eccentricity index,and lower tricuspid annular plane systolic excursion(TAPSE),maximum velocity of tricuspid annulus contraction(S'),right-side RVDS(R-RVDS)and left-side RVDS(L-RVDS)(P<0.05).The area under the curve(AUC)of RVD,interventricular septal eccentricity index,TAPSE,S',maximum tricuspid regurgitation velocity,pulmonary arterial systolic pressure and R-RVDS was 0.765,0.750,0.770,0.780,0.707,0.723 and 0.682,respectively.TAPSE combined with R-RVDS had a sensitivity of 92.0%,specificity of 76.2%and AUC value of 0.850.Correlation analysis showed that R-RVDS and L-RVDS were positively correlated with glomerular filtration rate(r=0.514 and 0.544,respectively),but negatively correlated with creatinine(r=-0.337 and-0.484,respectively).Conclusion Right heart ultrasound index combined with renal vascular doppler score has higher evaluation and predictive value for patients who need re-dialysis with end-stage renal disease.
作者
刘奕
赵浩天
王晓娜
刘元琳
李丽
王泽凯
Liu Yi;Zhao Haotian;Wang Xiaona;Liu Yuanlin;Li Li;Wang Zekai(Department of Ultrasound,Hebei General Hospital,Shijiazhuang 050000,China;Department of Nephrology,Hebei General Hospital,Shijiazhuang 050000,China)
出处
《临床荟萃》
2025年第1期54-59,共6页
Clinical Focus
基金
河北省医学科学研究课题计划项目——肺超声联合下腔静脉变异度在血液透析患者容量评估的应用(20200714)
河北省医学科学研究课题计划项目——心肺超声联合技术对急性呼吸循环功能障碍诊疗效能的研究(20211228)。
关键词
肾功能衰竭
慢性
超声检查
多普勒
肾透析
肾脏血流
右心功能
kidney failure,chronic
ultrasonography,doppler
renal dialysis
renal vascular
right heart function
