儿童肾动脉多普勒超声正常参考值及其临床意义

摘要

目的 探讨多普勒超声测量正常儿童肾动脉血流参数的正常参考值及其临床意义.方法 随机选取319名1天～16岁正常儿童,男192名,女127名,以多普勒超声测量双侧肾脏的肾动脉血流参数,包括收缩期峰值流速(Vs)、舒张末期峰值流速(Vd)、平均血流速度(Vm)、收缩期峰值流速与舒张末期峰值流速比值(S/D)、搏动指数(PI)、阻力指数(RI)和收缩期血流加速时间(AT)；分析各参数随年龄、体表面积(BSA)的变化趋势.结果 男性与女性儿童及左侧与右侧肾动脉各项血流参数差异均无统计学意义(P均＞0.05)；正常儿童BSA与年龄呈正相关(r=0.96,P＜0.01),与肾动脉血流速度及RI分别呈正相关与负相关(P均＜0.05)；除AT外,肾动脉血流速度和RI以肾主动脉、段动脉、叶间动脉依次递减(P＜0.05).结论 正常儿童肾动脉多普勒超声血流参数与BSA相关,可作为儿童肾脏疾病诊断的正常参考值.%Objective To obtain normal values of renal arterial blood flow parameters in healthy children with Doppler ultrasound.Methods Totally 319 healthy children aged from 1 day to 16 years (192 males and 127 females) were randomly enrolled.All the parameters of renal artery in both kidneys,including peak systolic velocity (Vs),end-diastolic velocity (Vd),mean flow velocity (Vm),peak systolic velocity/end-diastolic velocity (S/D),pulsatility index (PI),resistance index (RI) and systolic acceleration time (AT) were evaluated with Doppler ultrasound.The relationship between all the parameters and age as well as body surface area (BSA) were analyzed.Result There was no difference between male and female children,nor between left and right in the renal arterial parameters (all P＞0.05).There was significant correlation between BSA and age of normal children (r=0.96,P＜0.01).BSA of normal children correlated positively and negatively with renal arterial blood velocities and RI,respectively (all P＜0.05).All the parameters except AT decremented in the order of main renal artery,segmental artery and interlobar artery.Conclusion Parameters of renal artery measured with Doppler ultrasound in healthy children which have strong correlation with BSA may be considered as normal reference values for the diagnosis of renal diseases.