肾多普勒参数和肾功能指标监测妊娠期妇女肾血流动力学变化的对比研究  

A comparative study of renal Doppler parameters and serum biochemical markers of renal function in monitoring renal hemodynamic changes during pregnancy

作　　者：潘义[1] 孙丽洲[1] 姜海风[1] 肖云山[1] 

机构地区：[1]南京医科大学第一附属医院妇产科,210029

出　　处：《中华超声影像学杂志》2007年第8期689-691,共3页Chinese Journal of Ultrasonography

基　　金：国家十五科技攻关项目（2004BA720A06-01）

摘　　要：目的：序贯研究妊娠期妇女肾血流动力学的生理性特征，并比较彩色多普勒超声和肾功能血生化指标在监测妊娠期妇女肾动脉血流特征中的作用。方法：随机对160例正常妊娠妇女通过彩色多普勒超声在孕10～14周、20～24周、30～34周以及50例非孕妇女监测肾动脉血流动力学三项参数（峰值流速／舒张末期流速、搏动指数和阻力指数），并同时检测血浆肾功能生化指标（肌酐、尿素氮和尿酸）。结果：①正常妊娠组肾主动脉和肾段动脉血流动力学多普勒参数与非孕对照组相比均升高，但仅20～24周差异有统计学意义（P〈0．05）。方差分析显示，肾主动脉搏动指数和肾段动脉三项血流参数在各孕期之间比较，差异有统计学意义（P〈0．05）。其中，20～24周较10～14周和30～34周升高，差异有统计学意义（P〈0．05）。②正常妊娠组肾功能指标与非孕对照组相比均降低，差异有统计学意义（P〈0.001）。这些指标随着妊娠的进展而逐渐升高，方差分析示在正常妊娠各孕期间差异有统计学意义（P〈0．001）。结论：随着妊娠进展，孕妇肾功能指标和肾动脉多普勒三项参数均发生显著改变，但彩色多普勒超声能更直接、无创地反映肾血流的变化。深入研究妊娠期肾血液循环的变化特征，有助于早期发现妊娠期肾病理改变，积极预防妊娠并发症的发生。Objective To investigate the physiologic characteristics of renal artery blood flow and to compare the effect of renal artery color Doppler ultrasonography and serum biochemical markers in monitoring renal hemodynamics of pregnant womem. Methods One hundred and sixty normal pregnant women and 50 non-pregnant women as controls were seleccted in a serial random study to measure three renal Doppler parameters（S/D,PI and RI） of the main and segmental renal artery and three renal serum biochemical markers（Cr, BUN and UA）. Waveforms and blood samples were obtained in 10th～14th gestational weeks,20th～ 24th gestational weeks and 30th～ 34th gestational weeks respectively, and the same measurements were also performed in controls. Results ①The three Doppler parameters of the main and segmental renal artery in the pregnant women were elevated compared with that in non-pregnant women. But a statistically variation only occured in the 20th～24th gestational weeks （ P 〈0.05）. ANOVA showed significant changes of PI of the main artery and all the parameters of segmental artery between different gestational weeks（ P 〈0.05）, and a significant increase in 20th～ 24th gestational weeks compared with 10th～14th and 30th～34th gestational weeks （ P 〈0.05）. ②The three markers of renal function（Cr, BUN and UA）were increased vesus non-pregnant controls,and they were in an significant increasing trend with the increase of gestational week（ P〈0.001）. Conclusions The three renal serum biochemical markers and Doppler parameters change greatestly during pregnancy, and the noninvasive color Doppler ultrasonography shows a more direct variation. These changes reflect the development and perpetual growth of the renal circulation and they will play a major role in finding renal pathologic changes early and preventing the abnormal gestational complications.

关 键 词：超声检查 多普勒 孕妇 肾 血液动力学现象 肾功能试验 

分 类 号：R686[医药卫生—骨科学]