目的 探究外周血中凝血指标和降钙素原(procalcitonin，PCT)的表达水平对脓毒症合并急性肾损伤(acute kidney injury，AKI)的诊断价值。 方法 回顾性选取2021年9月─2025年2月界首市人民医院收治的131例脓毒症患者的病历资料，根据是否合并AKI，将患者分为观察组55例(脓毒症合并AKI)和对照组76例(脓毒症)，比较凝血指标、PCT的水平，分析其对脓毒症合并AKI的诊断价值。结果 观察组活化部分凝血活酶时间(activated partial thromboplastin time，APTT)、纤维蛋白原(fibrinogen，FIB)、凝血酶时间(thrombin time，TT)、D-二聚体、PCT、血肌酐(serum creatinine，Scr)、尿素氮(blood urea nitrogen，BUN)和胱抑素C(cystatin C，Cys C)水平高于对照组(t=4.909、6.139、7.488、6.629、8.685、2.797、4.987、4.333，均P＜0.001)；Logistic回归分析显示APTT(OR=1.483，95% CI：1.293～1.700，P＜0.001)、FIB(OR=11.761，95% CI：4.902～28.217，P＜0.001)、TT(OR=5.755，95% CI：2.952～11.219，P＜0.001)、D-二聚体(OR=13.573，95% CI：5.192～35.482，P＜0.001)、PCT(OR=3.196，95% CI：1.946～5.249，P=0.036)、Scr(OR=1.073，95% CI：1.045～1.101，P＜0.001)、BUN(OR=1.030，95% CI：0.925～1.148，P＜0.001)和Cys C(OR=4.301，95% CI：2.546～7.268，P＜0.001)水平提高是脓毒症患者发生AKI的独立危险因素。APTT、FIB、TT、D-二聚体、PCT联合诊断脓毒症合并AKI的AUC为0.903(ZAPTT vs联合=3.215，PAPTT vs联合=0.001；ZFIB vs联合=3.458，PFIB vs联合=0.001；ZTT vs联合=2.437，PTT vs联合=0.015；ZD-二聚体 vs联合=3.681，PD-二聚体 vs联合＜0.001；ZPCT vs联合=2.519，PPCT vs联合=0.012)。 结论 凝血指标、PCT和肾功能指标的上升是脓毒症合并AKI发生的独立危险因素，凝血指标和PCT联合诊断效能良好。

Objective  To investigate the diagnostic value of peripheral blood coagulation parameters and procalcitonin (PCT) levels in sepsis‑associated acute kidney injury (AKI). Methods  Medical records of 131 septic patients admitted to Jieshou People’s Hospital from September 2021 to February 2025 were retrospectively selected. Patients were divided into an observation group (sepsis with AKI, n=55) and a control group (sepsis without AKI, n = 76). Coagulation parameters and PCT levels were compared between the two groups, and their diagnostic value for sepsis‑associated AKI was analyzed. Results  The observation group had significantly higher levels of activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D‑dimer, PCT, serum creatinine (Scr), blood urea nitrogen (BUN), and cystatin C (Cys C) than the control group (t=4.909, 6.139, 7.488, 6.629, 8.685, 2.797, 4.987, 4.333; all P＜0.001). Logistic regression analysis showed that elevated levels of APTT (OR=1.483, 95% CI: 1.293～1.700, P＜0.001), FIB (OR=11.761, 95% CI: 4.902～28.217, P＜0.001), TT (OR=5.755, 95% CI: 2.952～11.219, P＜0.001), D‑dimer (OR=13.573, 95% CI: 5.192～35.482, P＜0.001), PCT (OR=3.196, 95% CI: 1.946～5.249, P=0.036), Scr (OR=1.073, 95% CI: 1.045～1.101, P＜0.001), BUN (OR=1.030, 95% CI: 0.925～1.148, P＜0.001), and Cys C (OR=4.301, 95% CI: 2.546～7.268, P＜0.001) were independent risk factors for AKI in septic patients. The area under the curve (AUC) of the combined diagnosis using APTT, FIB, TT, D‑dimer, and PCT for sepsis‑associated AKI was 0.903(ZAPTT vs. combined=3.215, P=0.001; ZFIB vs. combined =3.458, P=0.001; ZTT vs combined=2.437, P=0.015; ZD-dimer vs. combined=3.681, P＜0.001; ZPCT vs. combined=2.519, P=0.012).  Conclusion  Elevated coagulation parameters, PCT, and renal function indices are independent risk factors for sepsis-associated AKI. The combination of coagulation parameters and PCT demonstrates good diagnostic performance.