超声多普勒肾血流动力学测定对妊娠期高血压肾损害的研究

发布时间：2018-03-31 11:52

本文选题：彩色多普勒超声　切入点：妊娠期高血压病　出处：《南京医科大学学报(自然科学版)》2015年12期

【摘要】：目的 :应用彩色超声多普勒观察妊娠期高血压患者肾动脉血流动力学的变化,探讨其在此病患者早期肾损害中的诊断价值。方法:选择南京医科大学附属南京妇幼保健院待产分娩的子痫前期患者40例(PE组)、慢性高血压并发子痫前期25例(慢高合并PE组)、妊娠合并慢性高血压21例(慢高组)、妊娠期高血压患者22例(GH组)和正常妊娠孕妇48例(正常妊娠组)为研究对象。于妊娠32~36周检测孕妇血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)和肾小球滤过率(GFR),同时采用彩色超声多普勒超声诊断仪对各组孕妇进行肾脏血流动力学检测。结果:1 PE组及慢高合并PE组中血BUN、UA明显高于正常妊娠组和慢高组(P0.05);PE组Scr值明显高于慢高组、GH组及正常妊娠组,而GFR值明显低于这3组(P0.05);2 PE组、慢高合并PE组和慢高组3组肾主动脉(MRA)及段动脉(SRA)的血流峰值加速时间(AT)明显高于正常妊娠组(P0.05);GH组仅段动脉的血流峰值加速时间(AT)值高于正常妊娠组,而在主动脉此两组间AT值无差异;5组间MRA及SRA收缩期最大血流速度(Vs)、舒张期末血流速度(Vd)和阻力指数(RI)均无明显差异(P0.05)。结论:妊娠期高血压病时,子痫前期较慢性高血压所引起的肾损害更迅速、更严重。用肾脏超声多普勒测定各级肾动脉的AT是早期发现肾损害的敏感指标,其联合UA及GFR可为临床早期评价肾功能、制定治疗方案提供可靠依据。
[Abstract]:Objective: to observe the changes of renal artery hemodynamics in patients with hypertension complicating pregnancy by color Doppler ultrasound. Methods: 40 cases of preeclampsia and 25 cases of chronic hypertension complicated with preeclampsia were selected from Nanjing Maternal and Child Health Hospital of Nanjing Medical University. Serum creatinine was detected in 21 cases of pregnancy complicated with chronic hypertension (slow high pregnancy group, 22 cases of GH group with gestational hypertension) and 48 cases of normal pregnant women (normal pregnancy group). Serum creatinine was detected at 32 ~ 36 weeks of gestation. Scrr, bun, UAA and GFRV were used to detect renal hemodynamics of pregnant women in each group. Results the blood Bun UA was significantly higher in the 1 PE group than in the slow and high PE group, and the glomerular filtration rate (GFRV) was significantly higher than that in the low and high PE group, and the renal hemodynamics of the pregnant women in each group was detected by color Doppler ultrasound. The Scr values in normal pregnancy group and slow high pregnancy group were significantly higher than those in chronic high pregnancy group and normal pregnancy group. The GFR value of the three groups was significantly lower than that of the three groups. The peak acceleration time (ATT) of renal aorta (MRAs) and segmental artery (SRAs) were significantly higher than those of normal pregnancy group (P0.05) and normal pregnancy group (P 0.05), and the ATT value of segmental artery was significantly higher than that of normal pregnancy group. But there was no significant difference in AT value between the two groups. There was no significant difference in peak systolic velocities of MRA and SRA, peak diastolic velocity (VD) and resistance index (RI) between the five groups. Conclusion: during gestational hypertension, there is no significant difference between the two groups (P 0.05). The renal damage caused by preeclampsia is faster and more serious than that caused by chronic hypertension. The detection of AT in renal arteries by renal ultrasound Doppler is a sensitive index for early detection of renal damage. The combination of UA and GFR can be used to evaluate renal function early in clinic. To provide reliable basis for the formulation of treatment plan.
【作者单位】：南京医科大学附属南京妇幼保健院产科;
【基金】：国家自然科学基金-青年科学基金项目(81200442) 江苏省卫生厅指导性科研课题(Z201309) 南京市卫生青年人才培养工程基金(QRX11209)
【分类号】：R714.246

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