新生儿窒息合并胎粪吸入综合征肾血流动力学的超声研究

doi:10.3969/j.issn.1671-7171.2017.03.018

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract 【Objective】To investigate the ultrasonographic characteristics of renal hemodynamics in mild asphyxia neonates with meconium aspiration syndrome (MAS). 【Methods】Thirty cases of full-term newborns with mild asphyxia from July 2015 to July 2016 in our hospital were collected for the research. According to whether or not they had meconium aspiration syndrome (MAS), the patients were divided into two groups: group A (15 cases without MAS) and Group B (15 cases with MAS). At the same time, 16 healthy full-term newborn infants were selected as group C (the control group). The hemodynamic parameters of the bilateral main renal artery were detected by color Doppler while the baby was sleeping quietly. Systolic peak systolic velocity (PSV), end - diastolic velocity (EDV) and resistance index (RI) were measured on d₁, d₃ and d₇ after birth. 【Results】The PSV and EDV values of group A and B on d₁ were lower than those of group C (P<0.05), while RI values were higher than that of group C (P<0.05). The EDV of group B on d₁ was lower than that of group A, and the RI was higher than that of group A (P<0.05). Both PSV and EDV of group B on d₃ were lower than those of group A and group C; the difference was statistically significant (P<0.05). There were no significant differences in PSV,EDV and RI on d₇ between group A and group B (P>0.05). The PSV and EDV of group A were the lowest and the RI was the highest on d₁ after birth, after which the PSV and EDV increased gradually while the RI decreased gradually on d₃ and d₇. Finally the differences of PSV,EDV and RI of group A between d₁ and d₇ were statistically significant (P<0.05). The PSV and EDV of group B were both low and RI was the highest on d₁, then the PSV on d₃ was further reduced while the EDV was slightly increased and RI became the lowest on d₃. On d₇, all of PSV, EDV and RI in group B were increased; PSV increased the most. The differences of PSV,EDV and RI of group B between d₁ and d₇ were statistically significant (P<0.05). In group C, PSV and EDV showed a tendency to increase gradually, while RI showed a decreasing tendency, but the different trends among them were not statistically significant(P＞0.05). 【Conclusion】In neonates with mild asphyxia, the renal blood supply is reduced. it is more obvious in diastolic (EDV). When accompanied with MAS, the renal blood flow decreases even more significantly, and it will last longer and take slower recovery. Our research suggested that color Doppler ultrasonography can detect the change of renal blood supply to provide useful information for clinical treatment.

Key words： Asphyxia Neonatorum/CO Meconium Aspiration Syndrome/CO Renal Artery/US Ultrasonography, Doppler Hemodynamics

Received: 06 January 2017

PACS:

R722.12

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2017.03.018 OR http://www.jcr.net.cn/EN/Y2017/V34/I3/471

[1] Alaro D, Bashir A, Musoke R,et al. Prevalence and outcomes of acute kidney injury in term neonates with perinatal asphyxia [J]. Afr Health Sci, 2014, 14(3):682-688.
[2] Durkan AM, Alexander RT. Acute Kidney Injury Post Neonatal Asphyxia[J]. J Pediatr, 2011, 158(2 Suppl):e29-33.
[3] Lee JH, Romero R, Lee KA, et al. Meconium aspiration syndrome: a role for fetal systemic inflammation[J]. Am J Obstet Gynecol, 2016, 214(3):366.e1-e9.
[4] 金汉珍,黄德珉,官希吉.实用新生儿学[M].第3版.北京:人民卫生出版社,2003:401.
[5] Hankins GD, Koen S, Gei AF, et al. Neonatal organ system injury in acute birth asphyxia sufficient to result in neonatal encephalopathy[J]. Obstet Gynecol, 2002, 99(1):688-691
[6] Wiedemann JR, Saugstad A, Barnespowell L, et al. Meconium Aspiration Syndrome[J]. Z Geburtshilfe Neonatol, 2008, 200(4):132-137.
[7] Bouglé A, Duranteau J. Pathophysiology of sepsis-induced acute kidney injury: the role of global renal blood flow and renal vascular resistance[J]. Contrib Nephrol, 2011, 174:89-97.
[8] 李明星, 罗志建, 陈晓梅,等. 彩色多普勒超声动态监测窒息新生儿肾动脉主干血流动力学的意义[J]. 中国医学影像学杂志, 2013,21(11):818-820.
[9] 袁柳, 陈红天, 夏晓辉,等. 梗阻性黄疸大鼠肾脏血流动力学变化的超声研究[J]. 医学临床研究, 2016, 33(3):490-493.
[10] Ilves P, Lintrop M, Talvik I, et al. Changes in cerebral and visceral blood flow velocities in asphyxiated term neonates with hypoxic-ischemic encephalopathy[J]. J Ultrasound Med, 2009, 28(11):1471-1480.
[11] Luciano R, Gallini F, Romagnoli C, et al. Doppler evaluation of renal blood flow velocity as a predictive index of acute renal failure in perinatal asphyxia[J]. Eur J Pediatr, 1998, 157(8):656-660.
[12] 吴捷, 李艳红, 魏克伦,等. 胎粪吸入综合征患儿肾血流动力学的改变[J]. 中国医科大学学报, 2001, 30(5):393-395.
[13] Konkalmatt PR, Asico LD, Zhang Y, et al. Renal rescue of dopamine D2 receptor function reverses renal injury and high blood pressure[J]. JCI Insight, 2016, 1(8):e85888.