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早产儿肾脏初始大小及出生后生长情况的超声研究

Ultrasonographic study of initial size and postnatal growth of kidneys in preterm infants.

作者信息

Lim Yun-Jung, Kim Woo Sun, Kim Han-Suk, Choi Young Hun, Cheon Jung-Eun, Shin Su-Mi, Kim In-One, Choi Jung-Hwan

机构信息

Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Neonatology. 2014;106(2):107-13. doi: 10.1159/000358480. Epub 2014 May 17.

Abstract

BACKGROUND

Preterm birth is known to be associated with risks of impaired nephrogenesis.

OBJECTIVES

To determine the normal range of renal sizes at birth in preterm infants as well as their short-term postnatal renal growth, to assess the correlation between initial renal size and growth parameters at birth and to compare the initial and serial renal sizes between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) preterm infants.

METHODS

Initial ultrasonography (US) was prospectively performed in 125 preterm infants within the first 72 h of life and every 2 weeks thereafter until a postmenstrual age (PMA) of 37 weeks was reached. Correlation between renal size and growth parameters was investigated. Renal lengths of AGA and SGA preterm infants were compared with those of age-matched fetuses described in the literature.

RESULTS

The renal sizes at birth in preterm infants are presented. Multiple regression analysis showed the strongest correlation between initial renal size and birth weight (p < 0.0001). Initial renal lengths of AGA infants were not significantly different from those of age-matched fetuses at ≥30 weeks' gestational age (GA), whereas those of SGA infants were significantly smaller at ≥28 weeks' GA. Serial renal lengths of SGA infants were significantly smaller than fetal renal lengths at ≥30 weeks' GA.

CONCLUSION

With US, the normal range of initial renal sizes of AGA preterm infants was defined according to GA. In contrast to AGA infants, SGA infants showed smaller initial renal sizes and no significant catch-up growth until a PMA of 37 weeks.

摘要

背景

已知早产与肾发生受损风险相关。

目的

确定早产儿出生时肾脏大小的正常范围及其出生后短期内的肾脏生长情况,评估出生时初始肾脏大小与生长参数之间的相关性,并比较适于胎龄(AGA)和小于胎龄(SGA)早产儿的初始及系列肾脏大小。

方法

前瞻性地对125例早产儿在出生后72小时内进行首次超声检查(US),此后每2周检查一次,直至达到37周的月经龄(PMA)。研究肾脏大小与生长参数之间的相关性。将AGA和SGA早产儿的肾脏长度与文献中描述的年龄匹配胎儿的肾脏长度进行比较。

结果

列出了早产儿出生时的肾脏大小。多元回归分析显示初始肾脏大小与出生体重之间的相关性最强(p < 0.0001)。AGA婴儿在≥30周胎龄(GA)时的初始肾脏长度与年龄匹配胎儿的初始肾脏长度无显著差异,而SGA婴儿在≥28周GA时的初始肾脏长度明显较小。SGA婴儿的系列肾脏长度在≥30周GA时明显小于胎儿肾脏长度。

结论

通过超声检查,根据胎龄确定了AGA早产儿初始肾脏大小的正常范围。与AGA婴儿相比,SGA婴儿的初始肾脏大小较小,直到37周PMA时均无明显的追赶生长。

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