胎儿肾积水多参数超声评分与预后的Meta分析  

Meta-analysis of Multi-parameter Ultrasound Score and Prognosis of Antenatal Hydronephrosis

作　　者：莫有敏 王芸 曹显梅 MO You-min;WANG Yun;CAO Xian-mei(Department of Obstetrics and Gynecology Ultrasound,Affiliated Hospital of Guizhou Medical University,Guiyang 558000,Guizhou,China)

机构地区：[1]贵州医科大学附属医院妇产科超声,贵州贵阳558000

出　　处：《医学信息》2023年第14期70-75,共6页Journal of Medical Information

摘　　要：目的以肾实质厚度(RPT)、肾盂前后径(APD)、肾盂肾盏形态(PM)为观察指标,探讨胎儿肾积水(ANH)的多参数超声评分(MPUS)与出生后肾积水预后的关系,以期指导临床采取适当的应对措施。方法检索PubMed数据库、中国知网、中国生物医学文献数据库以及万方数据库1998-2022年收录的有关胎儿肾积水多参数超声评分的文献,以Newcastle-Ottawa Scale评价表对文献进行质量评价,采用Review Manager 5.4软件进行Meta分析,对纳入的文献进行异质性检验,合并分析胎儿肾积水超声评分与预后的关系。结果共纳入4篇文献,均为高质量文献,涉及582例胎儿共713只肾脏,根据先天性肾积水的预后分为生理性肾积水和病理性肾积水。当先天性肾积水的MPUS≤3分时,其预后为病理性肾积水的恶化率为0;MPUS为4~7分的胎儿产后恶化为病理性肾积水的恶化率分别为:MUPS=4分:15.2%(95%CI:0.09~0.25)、MUPS=5分:29.2%(95%CI:0.18~0.42)、MUPS=6分:48.7%(95%CI:0.33~0.64)、MUPS=7分:81.3%(95%CI:0.66~0.90);MPUS≥8分时,其预后为病理性肾积水的恶化率为100%。先天性肾积水胎儿预后为病理性肾积水的恶化率随MPUS评分增加而增加,绝大部分MPUS评分低的肾积水胎儿于出生前或出生后1年内好转。结论MPUS评分可以为先天性肾积水胎儿提供良好预后信息,其中先天性肾积水MPUS评分低的预后很少为病理性,MPUS评分高的预后大多为病理性,因此需要对各种程度的肾积水进行随访,尤其是MPUS评分高的肾积水胎儿,有助于及早发现病理性肾积水并及时给予治疗。Objective To investigate the relationship between multi-parameter ultrasound score(MPUS)and prognosis of antenatal hydronephrosis(ANH)with renal parenchymal thickness(RPT),anterior and posterior pelvis diameter(APD)and renal pelvis and calyceal morphology(PM),so as to guide the appropriate clinical response.Methods Literatures on multi-parameter ultrasound score of antenatal hydronephrosis collected in PubMed database,CNKI,CBM database and Wanfang database from 1998 to 2022 were retrieved.Newcastle-Ottawa Scale was used to evaluate the quality of the literature.Review Manager 5.4 software was used for meta-analysis.Heterogeneity test was performed on the included literature,and the relationship between ultrasound score of fetal hydronephrosis and prognosis was analyzed.Results A total of 4 articles were included,all of which were of high quality.A total of 582 cases and 713 kidneys met the inclusion and exclusion criteria.According to the different prognosis of antenatal hydronephrosis,it was divided into two categories:physiologic hydronephrosis and pathological hydronephrosis.When the MPUS of ANH was less than 3 scores,the prognosis was that the deterioration rate of pathological hydronephrosis was 0.For antenatal hydronephrosis with MPUS of 4-7 scores,the rate of postpartum deterioration to pathological hydronephrosis was:MUPS=4 scores:15.2%(95%CI:0.09-0.25),MUPS=5 scores:29.2%(95%CI:0.18-0.42),MUPS=6 scores:48.7%(95%CI:0.33-0.64),MUPS=7 scores:81.3%(95%CI:0.66-0.90);when MPUS≥8 scores,the prognosis of pathological hydronephrosis was 100%.The prognosis of ANH was that the worsening rate of pathological hydronephrosis increased with the increase of MPUS score.Most hydronephrosis with low MPUS score improved before birth or within 1 year after birth.Conclusion MPUS score of antenatal hydronephrosis can provide good prognostic information.The prognosis of antenatal hydronephrosis with low MPUS score is rarely pathological,while the prognosis of antenatal hydronephrosis with high MPUS score is mostly pathologica

关 键 词：胎儿肾积水 多参数超声评分法 病理性肾积水 

分 类 号：R455.1[医药卫生—运动医学]