超声评估孕中期胎儿肾脏体积及肾动脉血流的临床研究  

Clinical study of ultrasound in evaluating renal arterial blood flow and renal volume in the second trimester

作　　者：张朋燕 任苓 程玲 邱钧钰 曾庆新 程芳玲 刘景莲 ZHANG Peng-yan;REN Ling;CHENG Ling;QIU Jun-yu;ZENG Qing-xin;CHENG Fang-ling;LIU Jing-lian(The First Clinical Medical School,Gannan Medical University;Department of Ultrasound,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医科大学第一临床医学院 [2]赣南医科大学第一附属医院超声医学科,江西赣州341000

出　　处：《赣南医科大学学报》2024年第11期1145-1151,共7页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣南医学院研究生创新专项资金项目(YC2021-S792)。

摘　　要：目的:探究孕中期正常胎儿肾脏体积(Rennal volume,RV)及肾动脉(Rennal artery,RA)血流动力学参数,比较肾积水胎儿与相应孕周正常胎儿的RV、RA血流动力学参数。方法:收集2020年10月至2022年12月在赣南医科大学第一附属医院就诊的单胎孕妇394例,年龄20~45岁,孕22~26+6周,根据产前超声检查结果及临床表现将孕妇分为正常组和病例组。运用二维超声对胎儿RA血流动力学参数及肾脏各径线进行测量,采用Pearson相关分析法对正常胎儿肾脏血流动力学各参数与孕周进行相关性分析,比较正常胎儿与相应孕周肾积水胎儿肾脏参数,分析肾积水胎儿的检查及随访结果。结果:同一胎儿左、右肾脏各个参数测量值间虽略有差异,但差异无统计学意义(P>0.05),胎儿RV及RA血流动力学参数与孕周的相关性显示,RV、收缩期峰值血流流速(Peak systolic velocity,PSV)、舒张末期血流流速(End diastolic velocity,EDV)与孕周呈正相关,血管收缩期峰值与舒张末期的速度比(Peak systolic to end diastolic flow velocity,S/D)、搏动指数(Pulsation index,PI)、阻力指数(Resistance index,RI)与孕周呈负相关(P<0.05)。单因素方差分析发现,孕22~23+6周和孕24~26+6周正常肾脏与肾积水胎儿(轻度、中度、重度)肾脏参数差异均有统计学意义(P<0.05)。孕22~23+6周轻度、中度肾积水肾脏与正常肾脏长径(Renal length,RL)、厚径(Renal thickness,RT)、宽径(Renal width,RW)、RV比较,差异有统计学意义(P<0.05),PSV、EDV、S/D、PI、RI比较差异无统计学意义(P>0.05);孕24~26+6周轻度、中度、重度肾积水肾脏与正常肾脏RL、RT、RW、RV比较,差异有统计学意义(P<0.05),PSV、EDV、S/D、PI、RI比较差异无统计学意义(P>0.05)。在肾积水肾脏中,轻度及中度肾积水肾脏的胎儿在出生前逐渐好转,出生后超声复查肾脏形态大小、实质回声、肾盂肾盏结构与正常胎儿肾脏无差异。其中,重度肾积水胎儿出生�Objective:To investigate the renal volume(RV)and renal artery(RA)hemodynamic parameters of normal fetuses during mid-pregnancy,and to compare these parameters between fetuses with hydronephrosis and corresponding gestational age normal fetuses.Methods:A total of 394 singleton pregnant women aged 20-45 years,with gestational ages between 22 to 26+6 weeks,who visited The First Affiliated Hospital of Gannan Medical University from October 2020 to December 2022,were included in the study.Based on prenatal ultrasound findings and clinical manifestations,they were divided into a normal group and a case group.Two-dimensional ultrasound was used to measure the RA hemodynamic parameters and the various dimensions of the fetal kidneys.The correlation of hemodynamic parameters with gestational age in normal fetuses was analyzed,and comparisons were made between the renal parameters of normal fetuses and those with hydronephrosis at the corresponding gestational age.The examination and follow-up results of fetuses with hydronephrosis were also analyzed.Results:Although there were slight differences in the measurements of the left and right kidneys of the same fetus,these differences were not statistically significant(P>0.05).The correlation analysis showed that peak systolic velocity(PSV),end diastolic velocity(EDV),and RV were positively correlated with gestational age,while peak systolic to end diastolic flow velocity(S/D),pulsatility index(PI),resistance index(RI)were negatively correlated(P<0.05).One-way ANOVA revealed statistically significant differences in renal parameters between normal kidneys and those with mild,moderate,and severe hydronephrosis at gestational weeks 22-23+6 and 24-26+6(P<0.05).For fetuses with mild and moderate hydronephrosis at 22-23+6 weeks,significant differences were observed in renal length(RL),renal thickness(RT),renal width(RW),and RV compared to normal kidneys(P<0.05),while PSV,EDV,S/D,PI,and RI showed no significant differences(P>0.05).At 24-26+6 weeks,significant differences were also fo

关 键 词：超声检查 胎儿 肾脏体积 肾动脉 肾积水 

分 类 号：R714.53[医药卫生—妇产科学]