正常小儿肾脏血流阻力的研究

Renal vascular resistance in normal infants and children

目的 探讨正常小儿肾脏阻力指数、搏动指数随小儿生长发育的变化情况为临床监测肾脏病理生理变化提供参考。方法 正常小儿 10 4名 (共 2 0 8侧肾脏 ) ,年龄 2 3d～ 12岁 (平均 6 .0 3岁 ) ,按年龄分为 4组 (≤ 1岁、1～ 3岁、4～ 7岁、≥ 8岁 ) ,使用彩色多普勒超声测量肾动脉、叶间动脉的收缩期最大血流速度、舒张期最小血流速度、阻力指数、搏动指数。比较各项参数在年龄组间的差异并采用回归分析计算出阻力指数和搏动指数随小儿年龄、体重变化的曲线方程。结果 小儿肾脏血管阻力随年龄和体重的增加而持续下降。阻力指数、搏动指数与年龄、体重呈负相关关系 ,新生儿期分别为 0 .85± 0 .0 3和 1.75± 0 .0 4 ,12岁时降为 0 .6 2± 0 .0 3和 1.2 4± 0 .14。结论 小儿肾脏血流阻力随生长发育而逐渐降低 ,应用阻力指数和搏动指数诊断肾脏疾病时应根据不同年龄参照不同的正常值。

Objective To correlate renal vascular resistance parameters including resistance index (RI), pulsatility index (PI), systolic velocity, diastolic velocity with age and body weight in normal infant and children using the ultrasonography.Methods One hundreds and four normal infants and children (23 days to 12 years of age, mean 6.03 years) were involved in this study. The systolic velocity, diastolic velocity, RI and PI of renal and interlobar artery were examined with color Doppler ultrasound. The differences of these parameters between the different age groups were compared and the regression analysis was performed.Results Renal vascular resistance decreased with age and increased with body weight until 12 years of age. The differences of RI, PI between the different age groups were significant. The RI and PI were 0.85 ± 0.03 and 1.75 ± 0.04 in newborn, and 0.62 ± 0.03 , 1.24 ± 0.14 in 12 year old children respectively.Conclusions RI and PI are decreased with the increasing of age and body weight. This highlights the importance of different reference values in assessing pediatric renal function.