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目的探讨足月适于胎龄(AGA)儿、早产小于胎龄(SGA)儿、足月SGA儿间肾血流参数的关系。方法采用彩色多普勒超声技术监测66名AGA儿、48例早产AGA儿、56例早产SGA儿、44例足月SGA儿生后第1、3、7天肾动脉血流动力学参数(收缩期峰值流速、舒张末期流速、阻力指数、搏动指数)变化。结果足月AGA儿阻力指数(RI)、搏动指数(PI)较早产AGA儿低(P<0.01);而收缩期峰值流速(PSFV)、舒张末期流速(EDFV)则高于AGA儿。与足月AGA儿比较,足月SGA儿的PSFV、EDFV在日龄第1、3、7天均显著减低(P<0.01,P<0.05),而其RI则增高(P<0.05),其差异有统计学意义。与早产SGA儿相比,足月SGA儿的PSFV在日龄第1、3天显著减低(P<0.01,P<0.05),而RI则显著增高(P<0.01,P<0.05),其差异有统计学意义;在第7日龄足月SGA儿的PSFV、EDFV均减低,RI、PI均增高,但差异无统计学意义(P>0.05)。结论SGA儿存在肾动脉血流动力学改变,表现为肾血流灌注不良,其相关因素有早产、低出生体重,尤低出生体重影响更明显。
Objective To investigate the relationship between renal blood flow parameters in full-term suitable gestational age (AGA), premature labor with gestational age (SGA) and full-term SGA. Methods Color Doppler ultrasound was used to monitor the renal arterial hemodynamic parameters (systolic and diastolic parameters) in 66 AGA infants, 48 preterm AGA infants, 56 preterm SGA infants and 44 full term SGA infants on the 1st, Peak flow rate, end-diastolic flow rate, resistance index, pulsatility index) changes. Results The RI of full-term AGA and the PI were lower than those of premature AGA (P <0.01). However, the peak systolic velocity (PSFV) and end-diastolic velocity (EDFV) were higher than those of AGA. Compared with full-term AGA infants, the PSFV and EDFV of full-term SGA children decreased significantly (P <0.01, P <0.05) on day 1, day 3, and day 7, while their RI increased (P <0.05) The difference was statistically significant. Compared with preterm SGA infants, PSFV of full-term SGA children decreased significantly (P <0.01, P <0.05), while RI increased significantly (P <0.01, P <0.05) There was statistical significance. At the seventh day of age, the PSFV and EDFV in term full-term SGA children were decreased, RI and PI were increased, but the difference was not statistically significant (P> 0.05). Conclusions There is a change of hemodynamics of renal artery in SGA children, which is characterized by poor renal perfusion. The related factors are premature birth and low birth weight, especially the birth weight.