彩色多普勒超声在评价小儿肾积水肾脏单肾功能中的价值

Value of color Doppler Ultrasound in the Evaluation of Pediatric Hydronephrosis and Single Kidney Func- tion

【目的】探讨彩色多普勒超声检测肾脏皮质厚度（RPT ）、肾盂前后径（AP）在评价小儿先天性肾积水分肾功能的应用价值。【方法】收集2012年6月至2014年4月行肾脏彩超检查的单侧肾积水患儿64例，男49例，女15例。其中41例由手术证实为肾盂输尿管处梗阻，23例未做任何处理。于彩超检查后10 d内进行肾动态显像（SPECT ）检查测量肾小球滤过率（GFR ），根据测值将64个肾脏分为正常组（GFR＞34 mL／min）、肾功能轻度受损组（GFR 20～34 mL／min）、肾功能重度受损组（GFR＜20 mL／min），分别测量三组病例的 RPT、AP；采用 T 检验两两比较3组间测量的RPT、AP的差异，并用线性回归分析 RPT、AP 与同侧肾脏 GFR值的相关性。【结果】三组间 RPT 分别为（3．84±0．77）mm、（3．27±0．42）mm、（2．71±0．54）mm ；AP分别约（22．50±7．10）mm、（41．63±4．91）mm、（45．73±18．08） mm。RPT、AP在组间差异均有统计学意义（ P＜0．05）。RPT、AP 与单侧脏GFR均有良好的相关性（r＝0．764与 r＝－0．606，P ＜0．05）；当GFR下降到20％时，RPT 为2．04 mm ，AP为42．29 mm。【结论】彩超测量RPT、AP能在一定程度上的反映单侧肾功能，可以作为临床评价肾积水患儿单侧肾功能的有用参数。

[Objective] To explore the application value of renal cortex thickness and anthropometric diameter of renal pelvis in the evaluations of kidney function of congenital hydronephrosis .[Methods]Renal ultrasound was performed for 64 cases of unilateral hydronephrosis from April 2012 to June 2014 .There were 49 males and 15 females .Among them , 41 cases were confirmed operatively as ureterostenosis junction obstruction and 23 cases had no treatment at all .Ultra‐sound examination of renal dynamic imaging （SPECT ） was performed within 10 days to measure glomerular filtration rate （GFR） .Based on the measurements ,the kidneys were divided into normal group （GFR〉 34 mL/min） ,mildly impaired renal function group （GFR 20~34 mL/min） and severe renal impairment group （GFR 〈20 mL/min） .Renal parenchy‐mal thickness and anthropometric diameter of renal pelvis （AP） were measured .T test was used to compare the two‐two values of thickness of renal cortex and renal pelvis anteroposterior diameter .And linear regression was used to analyze the relationship between renal cortex thickness ,anteroposterior diameter of renal pelvis and ipsilateral renal GFR values .[Results] The values of renal cortex thickness for 3 groups were （3 .84 ± 0 .77） ,（3 .27 ± 0 .42） and （2 .71 ± 0 .54） mm respectively .And the values of anteroposterior diameter of renal pelvis were （22 .50 ± 7 .10） ,（41 .63 ± 4 .91） and （45 .73 ± 18 .08） mm respectively .Renal cortex thickness and anteroposterior diameter of renal pelvis had statistically significant differences （ P 〈0 .05） .Renal cortex thickness ,anthropometric diameter of renal pelvis and unilateral kidney GFR had excellent correlations （ r =0 .764 ＆ r = -0 .606 ,P 〈0 .05） .When GFR dropped to 20% ,renal cortex thickness was 2 .04 mm with an anteroposterior diameter of renal pelvis 42 .29 mm .[Conclusion] As measured by color Doppler ultra‐sound ,renal cortex thickness and anteroposterior diameter of renal pelvis may reflect the single kidney function .And both parameters are useful for evaluating single kidney function of hydronephrosis in children .