Pokharel R P, Uetani Y, Tsuneishi S, Nakamura H
Department of Pediatrics, Kobe University School of Medicine.
Kobe J Med Sci. 1997 Feb;43(1):1-12.
It is essential to evaluate the renal function for the management of high risk neonates. Color Doppler ultrasound technique can provide a useful information to evaluate the neonatal renal artery blood flow velocities. This study was performed to obtain the normative data of renal blood flow velocities in preterm and fullterm neonates and to compare the renal blood flow velocities with the aortic blood flow velocities. The normal volumetric state of fluid balance and renal function are essential in the management of the sick neonates.
The renal peak systolic blood flow velocity (renal PSFV), the renal mean blood flow velocity (renal MFV), the renal end diastolic blood flow velocity (renal EDFV) and the renal resistance index (renal RI) and also the cardiac output, the aortic peak systolic blood flow velocity (aortic PSFV) and the aortic mean blood flow velocity (aortic MFV) were serially recorded from one to 7 days after birth in 16 preterm and one to 5 days in 23 normal fullterm neonates.
The renal PSFV was significantly increased with the postnatal age, and the renal MFV was significantly increased between three and five days of age in the preterm neonates. In the fullterm neonates there was no significant change of the renal PSFV between one and five days of age, but the renal MFV was significantly increased between three and five days of age. There were no statistically significant differences of the renal PSFV, the renal MFV, the renal EDFV and the renal RI between the preterm and the fullterm neonates in the first five days after birth. The cardiac output in the preterm neonates was higher than that in the fullterm neonates: on day 3; 313 +/- 59 vs. 254 +/- 40 ml/kg/min. (p < 0.001) and on day 5; 357 +/- 95 vs. 280 +/- 35 ml/kg/min. (p < 0.01). The renal blood flow velocities were not significantly correlated with the aortic blood flow velocities in the normal fullterm neonates, whereas, in the preterm neonates the renal PSFV correlated with the cardiac output (r = 0.35, p < 0.01), the aortic PSFV (r = 0.45, p < 0.001) and the aortic MFV (r = 0.39, p < 0.01), and the renal MFV also correlated with the aortic PSFV (r = 0.30, p < 0.05) and the aortic MFV (r = 0.32, p < 0.05).
The increased renal flow velocities with the postnatal age in the preterm infants might depend on the increased cardiac output.
评估高危新生儿的肾功能对于其治疗至关重要。彩色多普勒超声技术可为评估新生儿肾动脉血流速度提供有用信息。本研究旨在获取早产儿和足月儿肾血流速度的正常参考数据，并比较肾血流速度与主动脉血流速度。在患病新生儿的治疗中，维持正常的液体平衡容积状态和肾功能至关重要。
对16例早产儿出生后1至7天以及23例正常足月儿出生后1至5天连续记录肾峰值收缩期血流速度（肾PSFV）、肾平均血流速度（肾MFV）、肾舒张末期血流速度（肾EDFV）和肾阻力指数（肾RI），同时记录心输出量、主动脉峰值收缩期血流速度（主动脉PSFV）和主动脉平均血流速度（主动脉MFV）。
早产儿的肾PSFV随出生后年龄显著增加，肾MFV在出生后3至5天显著增加。足月儿出生后1至5天肾PSFV无显著变化，但肾MFV在出生后3至5天显著增加。出生后前5天，早产儿和足月儿的肾PSFV、肾MFV、肾EDFV和肾RI无统计学显著差异。早产儿的心输出量高于足月儿：出生后第3天，分别为313±59与254±40 ml/kg/min（p<0.001）；出生后第5天，分别为357±95与280±35 ml/kg/min（p<0.01）。正常足月儿的肾血流速度与主动脉血流速度无显著相关性，而在早产儿中，肾PSFV与心输出量（r = 0.35，p<0.01）、主动脉PSFV（r = 0.45，p<0.001）和主动脉MFV（r = 0.39，p<0.01）相关，肾MFV也与主动脉PSFV（r = 0.30，p<0.05）和主动脉MFV（r = 0.32，p<0.05）相关。
早产儿肾血流速度随出生后年龄增加可能取决于心输出量的增加。
