Sturgiss S N, Martin K, Whittingham A, Davison J M
Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, Princess Mary Maternity Hospital, England.
Am J Obstet Gynecol. 1992 Nov;167(5):1250-4. doi: 10.1016/s0002-9378(11)91696-2.
A non-invasive method of assessing the renal vasculature during pregnancy would be useful in the management of patients with renal dysfunction resulting from preeclampsia or chronic renal disease. The objectives of this study were to determine (1) whether color ultrasonography during pregnancy facilitates Doppler interrogation of renal and intrarenal arteries, allowing (2) the assessment of differences between waveforms from nonpregnant and pregnant women and (3) the analysis of waveform variability throughout the kidney and between the right and left kidneys.
In a cross-sectional study renal and intrarenal artery flow waveforms were obtained from women in early (12 to 19 weeks; n = 8), mid (20 to 29 weeks; n = 11), and late (30 to 37 weeks; n = 14) pregnancy with eight age-matched, nonpregnant women acting as controls. Waveforms were analyzed for pulsatility index, resistive index, and systolic/diastolic ratio.
Left or right renal and upper- and lower-pole interlobar artery waveforms were obtained from all women. The mean pulsatility index values for the nonpregnant women were not significantly different from those women in early, mid, or late pregnancy. In the nonpregnant women, the left renal artery pulsatility index (1.13 +/- 0.13) was greater than the left lower interlobular artery pulsatility index (0.91 +/- 0.08; p < 0.05). During pregnancy renal and interlobar artery pulsatility index values were greater than those for the corresponding interlobular arteries, but the differences were not significant. Mean renal and intrarenal artery pulsatility index values were greater on the right, but the difference was significant only for the lower interlobular artery in midpregnancy.
Pregnancy does not significantly affect renal and intrarenal artery flow waveforms, nor are there significant differences between waveforms from the renal and interlobar arteries.
孕期评估肾血管系统的非侵入性方法有助于管理子痫前期或慢性肾病所致肾功能不全的患者。本研究的目的是确定：（1）孕期彩色超声检查是否有助于对肾动脉和肾内动脉进行多普勒检查，从而（2）评估非孕期和孕期女性波形的差异，以及（3）分析整个肾脏及左右肾之间波形的变异性。
在一项横断面研究中，从孕早期（12至19周；n = 8）、孕中期（20至29周；n = 11）和孕晚期（30至37周；n = 14）的女性获取肾动脉和肾内动脉血流波形，选取8名年龄匹配的非孕期女性作为对照。分析波形的搏动指数、阻力指数和收缩/舒张比。
所有女性均获得了左右肾及上下极叶间动脉波形。非孕期女性的平均搏动指数值与孕早期、孕中期或孕晚期女性的平均搏动指数值无显著差异。在非孕期女性中，左肾动脉搏动指数（1.13±0.13）大于左下小叶间动脉搏动指数（0.91±0.08；p<0.05）。孕期肾动脉和叶间动脉搏动指数值大于相应小叶间动脉的搏动指数值，但差异不显著。右肾及肾内动脉平均搏动指数值更高，但仅在孕中期右下小叶间动脉差异显著。
妊娠对肾动脉和肾内动脉血流波形无显著影响，肾动脉和叶间动脉波形之间也无显著差异。
