福罗塞米德压力测试和cystatin-C用于预测儿童急性损伤进展的诊断准确性:一项前性队列研究
S Dyvik1, Nisha Toteja2, Aliza Mittal1
1Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Indian journal of pediatrics
|January 18, 2025
概括
罗塞米德压力测试 (FST) 能够有效地预测儿童急性损伤 (AKI) 的进展情况,其准确性与囊素C水平相当. 这种床边工具有助于评估管管功能障碍和需要脏替代疗法 (KRT).
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 诊断生物标志物 诊断生物标志物
背景情况:
- 急性损伤 (AKI) 是儿科重症监护室 (PICU) 的一个重大问题.
- 早期识别AKI进展和需要置换疗法 (KRT) 对于患者的结果至关重要.
- 发胺应激试验 (FST) 和cystatin-C是评估功能的潜在生物标志物.
研究的目的:
- 为了评估furosemide压力测试 (FST),血清cystatin-C和尿液cystatin-C的预测性能.
- 识别有进入第三阶段AKI的风险的儿童,需要KRT.
- 为了比较FST的诊断准确性与儿科AKI中的cystatin-C水平.
主要方法:
- 一组儿童 (1个月至18岁) 患有KDIGO阶段-1/2 AKI入院到PICU被录取.
- 测量了罗胺压力测试 (FST) 和血清和尿液中囊素-C水平.
- 主要结局是进展到第3阶段AKI;次要结局包括KRT需要,停留时间和死亡率.
主要成果:
- 在41名儿童中,17.07%的AKI进展到第三阶段.
- 6小时后的FST显示出高预测值 (AUROC 0.87).
- 尿液囊素-C显示高灵敏度 (100%) 和AUROC (0.91) 预测阶段-3 AKI.
结论:
- 发胺应激试验 (FST) 是一个有价值的床边工具,用于预测儿童的AKI进展和管管功能障碍.
- FST的诊断准确度与尿液和血清中的cystatin-C.相美.
- 建议在更大的队列中进行进一步的研究,以提高概括性.
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