赣南医科大学学报2024，Vol.44Issue(11)：1145-1151,7.DOI:10.3969/j.issn.1001-5779.2024.11.010
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
摘要
Abstract
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 hydro-nephrosis 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 found in RL,RT,RW,and RV between kidneys with mild,moderate,and severe hydronephrosis and normal kidneys(P＜0.05),while PSV,EDV,S/D,PI,and RI showed no significant differences(P＞0.05).Among the kidneys with hydronephrosis,those with mild and moderate hydronephrosis showed gradual improvement before birth,and postnatal ultrasound revealed no differences in kidney morphology,size,echogenicity,or renal pelvis and calyx structure compared to normal fetuses.However,severe hydronephrosis persisted before birth,with regular follow-up ultrasounds showing a gradual decrease in hydronephrosis.One case of severe hydronephrosis followed from 24+5 weeks gestation showed a reduction in the left kidney's anteroposterior diameter(APD)from 15.32 mm to 7.12 mm over one year,with no significant abnormalities in renal function during the follow-up period.Conclusion:Establishing reference ranges for RV and RA hemodynamic parameters in mid-pregnancy fetuses is of significant theoretical value for the assessment of fetal kidney conditions.It provides a more comprehensive imaging basis for evaluating fetal renal growth and development,serving as an important guide for clinical diagnosis and treatment.关键词
超声检查/胎儿/肾脏体积/肾动脉/肾积水Key words
Ultrasonography/Fetal/Renal volume/Rennal artery/Antenatal hydronephrosis分类
医药卫生引用本文复制引用
张朋燕,任苓,程玲,邱钧钰,曾庆新,程芳玲,刘景莲..超声评估孕中期胎儿肾脏体积及肾动脉血流的临床研究[J].赣南医科大学学报,2024,44(11):1145-1151,7.基金项目
赣南医学院研究生创新专项资金项目(YC2021-S792) （YC2021-S792）
