Cleary G M, Higgins S T, Merton D A, Cullen J A, Gottlieb R P, Baumgart S
Department of Pediatrics, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
J Pediatr. 1996 Aug;129(2):251-7. doi: 10.1016/s0022-3476(96)70250-0.
Changes in color Doppler imaging measurements of renal artery blood flow velocity have been reported previously during fetal life and during the first week postnatally in term and preterm infants. This study reports longitudinal, developmental changes in renal artery and aortic blood flow velocities occurring postnatally, from birth to day 1 of life, at 1 week, and at 2 to 3 weeks of age in 14 premature babies (mean gestation, 30 +/- 4 (SD) weeks; birth weight, 1.45 +/- 0.57 kg), and identified by means of color Doppler imaging and pulsed Doppler spectral analysis. Results indicate that a significant increase in renal artery systolic blood flow velocity occurs within the first week of life (from 40 +/- 3 (SEM) cm/sec at birth or on day 1, to 53 +/- 3 cm/sec on day 7, to 51 +/- 4 cm/sec on day 14 to 21; repeated-measures analysis of variance, p = 0.004), concurrently with a significant increase in abdominal aortic blood flow velocities, both systolic (from 40 +/- 4 at birth or on day 1, to 70 +/- 8 on day 7, to 76 +/- 8 cm/sec on day 14 to 21; p <0.001) and diastolic (from 4 +/- 2 at birth or on day 1, to 11 +/- 2 on day 7, to 11 +/- 2 cm/sec on day 14 to 21; p = 0.00 1). Systemic blood pressure did not increase concomitantly during the some period. Neither the presence of respiratory distress syndrome or patent ductus arteriosus nor treatment with indomethacin altered developmental increases in observed renal artery blood flow velocities. The presence of an umbilical artery catheter in the high thoracic position in five infants, however, created turbulence at the level of the renal arteries, significantly increasing renal artery systolic flow velocity from 32 +/- 4 to 44 +/- 5 cm/sec (p = 0.009) and increasing renal resistive index from 0.90 +/- 0.03 to 0.96 +/- 0.04 (p = 0.046). These results suggest that renal artery blood flow velocity increases during the first postnatal week in preterm infants and is likely related to increases in aortic blood flow velocity and reduction in renal vascular resistance.
此前已有报道称，在胎儿期以及足月儿和早产儿出生后的第一周内，肾动脉血流速度的彩色多普勒成像测量值会发生变化。本研究报告了14例早产儿（平均孕周30±4（标准差）周；出生体重1.45±0.57千克）出生后从出生到出生后第1天、1周以及2至3周时肾动脉和主动脉血流速度的纵向发育变化，并通过彩色多普勒成像和脉冲多普勒频谱分析进行了确定。结果表明，出生后第一周内肾动脉收缩期血流速度显著增加（从出生时或第1天的40±3（标准误）厘米/秒，增加到第7天的53±3厘米/秒，再到第14至21天的51±4厘米/秒；重复测量方差分析，p = 0.004），同时腹主动脉血流速度也显著增加，包括收缩期（从出生时或第1天的40±4，增加到第7天的70±8，再到第14至21天的76±8厘米/秒；p<0.001）和舒张期（从出生时或第1天的4±2，增加到第7天的11±2，再到第14至21天的11±2厘米/秒；p = 0.
