下尿路梗阻胎儿的超声肾脏表现与尿液生物化学有关吗？

Are ultrasound renal aspects associated with urinary biochemistry in fetuses with lower urinary tract obstruction?

作者信息

Nassr Ahmed A, Koh Chester Koh, Shamshirsaz Alireza A, Espinoza Jimmy, Sangi-Haghpeykar Haleh, Sharhan Dina, Welty Stephen, Angelo Joseph, Roth David, Belfort Michael A, Braun Michael, Ruano Rodrigo

机构信息

Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA.

Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Asiut, Egypt.

出版信息

Prenat Diagn. 2016 Dec;36(13):1206-1210. doi: 10.1002/pd.4958. Epub 2016 Dec 1.

DOI:10.1002/pd.4958

PMID:27862070

Abstract

OBJECTIVE

To evaluate the association between ultrasonographic renal parameters and urine biochemistry in fetuses with lower urinary tract obstruction (LUTO).

METHODS

Data were collected prospectively from 31 consecutive fetuses with LUTO that underwent vesicocentesis for fetal urinary biochemistry between April 2013 and September 2015. The following renal ultrasound markers were assessed immediately before the vesicocentesis: renal echogenicity, presence of cortical cysts, presence of findings suggestive of 'renal dysplasia' (hyperechogenic cystic kidneys with no cortical-medullary differentiation) and severe oligohydramnios (amniotic fluid < 5th percentile). The association of these parameters to the fetal urinary concentration of sodium, chloride, calcium, osmolality and beta2-microglobulin was investigated by logistic regression analysis.

RESULTS

There was no relationship between any of the ultrasonographic fetal renal characteristics and fetal urinary biochemistry.

CONCLUSIONS

In LUTO, the ultrasound appearance of the fetal kidneys and urinary biochemistry are not correlated. It may be better to take both ultrasound and biochemistry into account when evaluating fetuses with fetal LUTO. © 2016 John Wiley & Sons, Ltd.

摘要

目的

评估下尿路梗阻（LUTO）胎儿的超声肾脏参数与尿液生化指标之间的关联。

方法

前瞻性收集了2013年4月至2015年9月期间连续31例接受膀胱穿刺术以检测胎儿尿液生化指标的LUTO胎儿的数据。在膀胱穿刺术前立即评估以下肾脏超声标志物：肾脏回声、皮质囊肿的存在、提示“肾发育不良”（无皮质-髓质分化的高回声囊性肾）的表现以及严重羊水过少（羊水<第5百分位数）。通过逻辑回归分析研究这些参数与胎儿尿液中钠、氯、钙、渗透压和β2-微球蛋白浓度的关联。