关键词: 床旁超声, 血尿素氮, D-二聚体, 脓毒症, 肾脏损伤, 诊断价值

Abstract: This paper aimed to explore the correlation between bedside ultrasonography, blood urea nitrogen (BUN) and D-dimer (D-D) in the diagnosis analysis of renal injury in children with sepsis. 60 children with suspected sepsis complicated with renal injury were selected as the research objects,and they were divided into renal injury (40 cases) and non-renal injury (20 cases). According to the level of 24 h urinary albumin excretion rate the renal injury group were divided into the severe renal injury group (n=22) and the moderate renal injury group (n=18). All children underwent bedside ultrasonography, BUN and D-D levels test. Compared with the non-kidney injury group, the inspiratory collapse rate of the inferior vena cava in the renal injury group were decreased, and the inner diameter of the inferior vena cava and the ventricular end-diastolic diameter (LVIDd) were higher (P<0.05). Compared with patients with mild renal injury, the inspiratory collapse rate of the inferior vena cava were lower in patients with moderate renal injury, and the inner diameter of the inferior vena cava and the level of LVIDd were higher (P<0.05). Compared with the children in the mild renal injury group, the BUN and D-D levels of the children in the moderate renal injury group were increased (P<0.05). The inner diameter of the inferior vena cava and LVIDd were positively correlated with the BUN and D-D levels. The inspiratory collapse rate of the inferior vena cava was negatively correlated with the levels of BUN and D-D (P<0.05). The area under the ROC curve (AUC) of bedside ultrasound combined with BUN and D-D monitoring in the diagnosis of sepsis complicated with renal injury were higher than those of single detection (P<0.05). Bedside ultrasound combined with BUN and D-D monitoring can improve the diagnostic accuracy and sensitivity of renal injury in children with sepsis.

Key words: bedside ultrasound, blood urea nitrogen, D-dimer, sepsis, kidney damage, diagnostic value