儿童急性肾功能衰竭肾动脉血流灌注的超声观测  

Investigation of Renal Artery Flow Perfusion in Children with Acute Renal Failuer by Color Doppler US

作　　者：郑名芳[1] 熊嗣钰[1] 杨杏鲜[1] 陈寿康[1] 张庆[1] 

机构地区：[1]武汉市儿童医院,湖北武汉430016

出　　处：《中国医学影像技术》2001年第11期1083-1085,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　研究儿童急性肾功能衰竭 (ARF)在不同病因 ,不同病程中肾脏声像图及血流变化。方法　ARF患儿 2 5例 ,健康儿童 40名为对照组。分别于少尿期、多尿期、恢复期进行观察 ,观察指标 :肾脏大小、回声、肾皮质血流分布、各级肾动脉Vmax、Vmin、RI。结果　少尿期及多尿期两组 2 5例肾脏肿大 ;少尿期第一组肾皮质血流为Ⅱ Ⅲ级 ,MRA、ILRA呈高速、高阻改变 ,第二组肾皮质血流Ⅰ级占 75 % ,MRA低速、低阻 ,ILRA低速、高阻改变 ,两组间各血流参数有极显著差异 ;多尿期两组肾血流均明显改善 ,恢复期肾内血流恢复正常。结论　①非肾小球性及肾小球性ARF、肾脏血流变化明显不同 ,二维声像图相同。②正常儿童ILRA的RI <0 .5 7± 0 .0 1,非肾小球性ARF时达 0 .87±0 .0 2 ,肾小球性ARF时RI为 0 .6 7± 0 .0 2。③MRA的Vmax及RI过低对肾脏不能形成有效灌注。④肾血流变化与病情变化一致 ,声像图改变不能反映肾功能好坏。Objective The goal of our study was to characterize alterations in the 2 D image and Doppler waveform associated with different types of ARF and different stage of ARF.Methods 25 cases of acute renal failuer(ARF) were divided into two groups: nonglomerular ARF (first group) and glomerular ARF (second group). There were 40 control subjects. The observation markers were: the size and echo of kidney, Vmax, Vmin and RI of each grade of renal artery.Results The enlargement of kidneys of both groups could be observed in oliguria stage and diuresis stage. In oliguria stage, the MRA and ILRA of the first group presented high velocity and high resistance, the MRA of second group presented low velocity and low resistance and the ILRA of second presented low velocity and high resistance. The difference in Doppler flow parameters between two groups was statistically significant. In diuresis stage, the evidence improve of flow could be observed in both groups. In recovery stage, the normal flow could be observed.Conclusion ①The changes of flow of renal artery in nonglomerular ARF and glomerular ARF were different, but the 2 D image seemed the same. ②The RI of ILRA of normal children less than 0.57±0.01. The RI of nonglomerular ARF could reach 0.87±0.02 and glomerular ARF could reach 0.67±0.02. ③Too low Vmax of MRA could not be helpful for the perfusion of kidney. ④The change of renal flow was the same as the change of the ARF stage. The size and echo of kidney could not react the condition of renal function.

关 键 词：儿童 双功彩色多普勒 血液透析 急性 肾功能衰竭 

分 类 号：R726.92[医药卫生—儿科] R445.1[医药卫生—临床医学]