应用彩色多普勒超声技术监测新生儿窒息患儿肾血流动力学变化  

作　　者：廖高庆 于风辉 李辉[1] 梁金彩 

机构地区：[1]广州医科大学第六附属医院(清远市人民医院),511518

出　　处：《浙江临床医学》2023年第10期1521-1523,共3页Zhejiang Clinical Medical Journal

基　　金：广东省清远市社会发展领域自筹经费科技计划项目(200808124560659)。

摘　　要：目的探讨肾动脉血流监测对新生儿窒息肾脏损害的诊断价值。方法收集2021年1月至2022年12月本院新生儿科收治的90例新生儿,其中窒息新生儿50例(35例为轻度窒息,15例为重度窒息),正常对照组40例。分析窒息组与对照组肾动脉主干收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)及肾动脉RI/大脑前动脉RI比值[RI比值(肾/脑)]。结果窒息组(轻度及重度窒息)患儿肾动脉主干血流PSV、EDV值均低于对照组,RI值均高于对照组,差异均有统计学意义(P<0.001);重度窒息组肾动脉主干血流PSV、EDV值均低于轻度窒息组,RI值高于轻度窒息组,差异有统计学意义(P<0.05)。重度窒息组大脑前动脉血流RI值与对照组比较,差异有统计学意义(P<0.05);重度窒息组大脑前动脉血流RI值与轻度窒息组比较,差异有统计学意义(P<0.05);轻度窒息组大脑前动脉血流RI值与对照组比较,差异无统计学意义(P>0.05)。窒息组(轻度及重度窒息)肾动脉与大脑前动脉血流RI比值均高于对照组(P<0.05);重度窒息组(肾动脉与大脑前动脉血流)RI比值高于轻度窒息组,差异有统计学意义(P<0.05)。重度窒息组肌酐水平与对照组比较,差异有统计学意义(P<0.05);重度窒息组肌酐水平与轻度窒息组比较,差异有统计学意义(P<0.05);轻度窒息组肌酐水平与对照组比较,差异无统计学意义(P>0.05)。结论新生儿肾动脉主干血流PSV、EDV、RI值及RI比值(肾/脑)可以作为监测患儿肾脏损害的一项超声指标,早于肾功能血液检测指标对肾脏损害情况做出早期判断,并且RI比值(肾/脑)能更敏感的反映机体在缺氧、缺血情况下肾脏与颅脑血流重新分配的情况,对临床评估新生儿窒息肾损伤情况有一定的实用价值。Objective To investigate the diagnostic value of renal artery blood flow monitoring in kidney damage of neonatal asphyxia.Methods A total of 90 full-term neonates admitted to the neonatology department of our hospital from January 2021 to December 2022 were collected,including 50 cases of neonatal asphyxia(35 cases mild asphyxia,15 cases severe asphyxia)and 40 cases of the normal control group.The peak systolic flow rate(PSV),end-diastolic flow rate(EDV),resistance index(RI)and renal artery RI/anterior cerebral artery RI in the asphyxia group and the control group were analyzed.Results PSV and EDV values of renal artery main blood flow in the asphyxia group(mild and severe asphyxia)were lower than those in the control group,and RI values were higher than those in the control group,the differences were statistically significant(P<0.001).The PSV and EDV values of renal arterial main blood flow in the severe asphyxia group were lower than those in the mild asphyxia group,and RI values were higher than those in the mild asphyxia group,with statistical significance(P<0.05).The blood flow RI value of anterior cerebral artery in the severe asphyxia group was significantly different from that in the control group(P<0.05).The blood flow RI value of anterior cerebral artery in the severe asphyxia group was significantly different from that in the mild asphyxia group(P<0.05).There was no significant difference in anterior cerebral artery flow RI value between the mild asphyxia group and the control group(P>0.05).The ratio of renal artery to anterior cerebral artery flow RI in the asphyxia group(mild and severe asphyxia)was higher than that in the control group,and the differences were statistically significant(P<0.05).RI ratio of the severe asphyxia group(renal artery and anterior cerebral artery blood flow)was higher than that of the mild asphyxia group,and the difference was statistically significant(P<0.05).The creatinine level of the severe asphyxia group was significantly different from that of the control group(P<0.05

关 键 词：彩色多普勒 新生儿窒息 肾血流 

分 类 号：R722.12[医药卫生—儿科]