多普勒超声在肥胖症伴高血压儿童肾动脉狭窄筛查中的应用。
Utility of Doppler sonography for renal artery stenosis screening in obese children with hypertension.
机构信息
Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Department of Mathematical Sciences, Clemson University College of Engineering and Sciences, Clemson, SC, USA.
出版信息
J Clin Hypertens (Greenwich). 2018 Apr;20(4):807-813. doi: 10.1111/jch.13241. Epub 2018 Mar 25.
Pediatric hypertension guidelines recommend Doppler renal ultrasonography as a screening study for the evaluation of possible renal artery stenosis (RAS) in normal-weight children ≥ 8 years of age who are suspected of having RAS and who will cooperate with the procedure. Obese children are excluded because of technical and vascular concerns. There are no data on RI in obese children. This is a retrospective review of children aged 1.5-18 who received Doppler imaging studies over a 10-year period. A total of 174 patients were studied. There was no significant difference between the RI values based on BMI. Of the 174 individuals in the study 22 obtained follow-up CT/MRA after abnormal Doppler ultrasounds. On advanced imaging 3 were confirmed to have RAS. Obesity does not seem to influence RI.RI alone should not be used as a screening tool for RAS. An approach toward diagnosis is suggested based on BMI, renin levels, and ultrasound.
儿科高血压指南建议对疑似存在肾动脉狭窄（RAS）且能配合检查的正常体重≥8 岁儿童进行多普勒肾脏超声检查作为筛查研究。由于技术和血管问题，肥胖儿童被排除在外。肥胖儿童的 RI 数据尚不清楚。这是对过去 10 年期间接受多普勒成像研究的 1.5-18 岁儿童进行的回顾性研究。共研究了 174 名患者。基于 BMI 的 RI 值无显著差异。在研究的 174 个人中，22 个在异常多普勒超声后获得了随访 CT/MRA。在高级成像中，有 3 人被证实存在 RAS。肥胖似乎不会影响 RI。RI 不应单独用作 RAS 的筛查工具。建议根据 BMI、肾素水平和超声检查来进行诊断。
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