早产儿和足月儿肾脏形态与功能的评估  

Assessment of renal function and renal morphology in preterms and term newborns

作　　者：徐千雅[1] 张茜[1] 程欣茹[1] 贺晓[1] 王丽[1] 张姗姗[1] 时赞扬[1] 刘楠[1] 晏晓敏[1] 文建国[2,3] Xu Qian ya;Zhang Qian;Cheng Xinru;He Xiao;Wang Li;Zhang Slumshan;Shi Zan ya ng;Liu Nan;YanXiaomin;Wen Jianguo(Department of Neonatology jhe First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002 , China;PediatricUrodynamic Centre, the First Affiliated Hospital of Zhengzhou Inirersity, Zhengzhou 450002 , China;Department ofPediatric Surgery the First Affiliated Hospital of Xinxiang Medical Iniversity, Weihui 453100, Henan Province, China)

机构地区：[1]郑州大学第一附属医院新生儿科,450002 [2]郑州大学第一附属医院小儿尿动力中心,450002 [3]新乡医学院第一附属医院小儿外科,河南卫辉453100

出　　处：《中华实用儿科临床杂志》2019年第7期525-528,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81670689).

摘　　要：目的探讨不同胎龄早产儿和足月儿肾脏体积与肾脏功能发育的关系。方法选取2016年10月至2018年3月郑州大学第一附属医院新生儿科住院的626例不同胎龄的新生儿,采用超声诊断仪测量并计算新生儿双侧肾脏体积;并检测记录肾功能(肌酐、尿素、尿酸、肾小球滤过率)。结果出生7 d的适于胎龄儿(出生体质量在同胎龄平均体质量的第10~90百分位的新生儿)入选,胎龄27~41+6周[(36.0±3.5)周];出生体质量0.90~3.82 kg[(2.59±0.77) kg];其中早产儿352例,男195例,女157例;足月儿274例,男147例,女127例。早产儿组肾脏体积[(19.57±4.30) cm^3]、肾小球滤过率[(21.68±5.99) mL/(min·1.73 m^2)]均低于足月儿组[肾脏体积(23.03±3.80) cm^3,肾小球滤过率(46.60±10.21) mL/(min·1.73 m^2)],差异均有统计学意义(t=12.96、33.10,均P<0.001)。肾脏体积与胎龄、出生体质量、身长呈正相关(r=0.546、0.605、0.592,均P<0.001)。肾脏体积与估算肾小球滤过率呈正相关(r=0.396,P<0.001),与尿素氮、肌酐、尿酸呈负相关(r=-0.210、-0.280、-0.176,均P<0.001)。结论早期新生儿肾脏体积随着胎龄、体质量增长而增大,肾小球滤过率随肾脏体积增大而增加。早产儿肾脏形态和功能发育较差应给予特别关注。Objective To explore the relationship between renal volume and function in the preterm and term newborns at different gestational ages. Methods This study was conducted at the First Affiliated Hospital of Zhengzhou University from October 2016 to March 2018.A total of 626 newborns with different gestational ages were included and the renal volume was determined by ultrasonography.Blood samples were taken for laboratory tests to detect renal function including urea, creatinine, uric acid and estimated glomerular filtration rate. Results A total of 352 preterm and 274 full term newborns were enrolled at birth.The mean gestational age of the neonates was (36.0±3.5) weeks and the mean birth weight was (2.59±0.77) kg.The mean renal volume of the preterm infants was (19.57±4.30) cm3 and estimated glomerular filtration was (21.68±5.99) mL/(min·1.73 m^2);the mean renal volume of the term infants was(23.03±3.80) cm3 and estimated glomerular filtration was(46.60±10.21) mL/(min·1.73 m^2). The renal volume and estimated glomerular filtration of term infants was significantly greater compared to the preterm infants(t=12.96, 33.10, all P<0.001). The renal volume was highly linear positively correlated with gestational age, birth weight and birth length(r=0.546, 0.605, 0.592, all P<0.001). The renal volume was highly linear positively correlated with estimated glomerular filtration(r=0.396, P<0.001). The renal volume was negatively correlated with urea, creatinine and uric acid(r=-0.210,-0.280,-0.176, all P<0.001). Conclusions The renal volume increases with gestational age and birth weight in neonates.Estimated glomerular filtration increases with renal volume in neonates.The preterm infants have immaturity kidney size and poor development so that they need special medical care.

关 键 词：早期新生儿 婴儿 早产 婴儿 足月 肾脏体积 肾功能 肾小球滤过率 

分 类 号：R722[医药卫生—儿科]