论文部分内容阅读
目的 :应用彩色超声多普勒观察妊娠期高血压患者肾动脉血流动力学的变化,探讨其在此病患者早期肾损害中的诊断价值。方法:选择南京医科大学附属南京妇幼保健院待产分娩的子痫前期患者40例(PE组)、慢性高血压并发子痫前期25例(慢高合并PE组)、妊娠合并慢性高血压21例(慢高组)、妊娠期高血压患者22例(GH组)和正常妊娠孕妇48例(正常妊娠组)为研究对象。于妊娠32~36周检测孕妇血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)和肾小球滤过率(GFR),同时采用彩色超声多普勒超声诊断仪对各组孕妇进行肾脏血流动力学检测。结果:1 PE组及慢高合并PE组中血BUN、UA明显高于正常妊娠组和慢高组(P<0.05);PE组Scr值明显高于慢高组、GH组及正常妊娠组,而GFR值明显低于这3组(P<0.05);2 PE组、慢高合并PE组和慢高组3组肾主动脉(MRA)及段动脉(SRA)的血流峰值加速时间(AT)明显高于正常妊娠组(P<0.05);GH组仅段动脉的血流峰值加速时间(AT)值高于正常妊娠组,而在主动脉此两组间AT值无差异;5组间MRA及SRA收缩期最大血流速度(Vs)、舒张期末血流速度(Vd)和阻力指数(RI)均无明显差异(P>0.05)。结论:妊娠期高血压病时,子痫前期较慢性高血压所引起的肾损害更迅速、更严重。用肾脏超声多普勒测定各级肾动脉的AT是早期发现肾损害的敏感指标,其联合UA及GFR可为临床早期评价肾功能、制定治疗方案提供可靠依据。
OBJECTIVE: To observe the changes of renal artery hemodynamics in hypertensive patients with gestational hypertension by color Doppler sonography and to explore the diagnostic value of renal arterial hemodynamics in patients with early renal damage. Methods: 40 cases of preeclampsia (PE group), 25 cases of chronic hypertension complicated with preeclampsia (group of PE with slow high), 21 cases of pregnancy complicated with chronic hypertension (MOP) were selected from Nanjing Maternal and Child Health Hospital of Nanjing Medical University. Slow high group), 22 cases of gestational hypertension (GH group) and 48 normal pregnant women (normal pregnancy group) as the research object. Serum creatinine (Scr), blood urea nitrogen (BUN), serum uric acid (UA) and glomerular filtration rate (GFR) in pregnant women were detected at 32-36 weeks gestation. Color Doppler ultrasound Pregnant women with renal hemodynamic test. Results: The levels of BUN and UA in 1 PE group and those in the slow-PE combined PE group were significantly higher than those in the normal pregnancy group and the slow-high group (P <0.05). Scr in PE group was significantly higher than that in the control group, GH group and normal pregnancy group While GFR was significantly lower than those in the three groups (P <0.05). In the 2 PE group, the peak acceleration time of renal artery (MRA) and segment artery (SRA) ) Was significantly higher than that of the normal pregnancy group (P <0.05). The peak acceleration time (AT) of only the arteries in GH group was higher than that in the normal pregnancy group, but there was no difference in AT between the two groups in the aorta group MRA and SRA systolic blood flow velocity (Vs), end diastolic blood flow velocity (Vd) and resistance index (RI) were no significant difference (P> 0.05). CONCLUSIONS: Compared with chronic hypertension in preeclampsia, the renal damage caused by pregnancy-induced hypertension is more rapid and serious. Renal ultrasound Doppler measurement of renal arteries at all levels of AT is an early detection of renal damage sensitive indicators, combined with UA and GFR for early clinical evaluation of renal function, to provide a reliable basis for the treatment program.