本文選題：彩色多普勒超聲　切入點(diǎn)：妊娠期高血壓病　出處：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2015年12期

【摘要】：目的 :應(yīng)用彩色超聲多普勒觀察妊娠期高血壓患者腎動(dòng)脈血流動(dòng)力學(xué)的變化,探討其在此病患者早期腎損害中的診斷價(jià)值。方法:選擇南京醫(yī)科大學(xué)附屬南京婦幼保健院待產(chǎn)分娩的子癇前期患者40例(PE組)、慢性高血壓并發(fā)子癇前期25例(慢高合并PE組)、妊娠合并慢性高血壓21例(慢高組)、妊娠期高血壓患者22例(GH組)和正常妊娠孕婦48例(正常妊娠組)為研究對象。于妊娠32~36周檢測孕婦血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)和腎小球?yàn)V過率(GFR),同時(shí)采用彩色超聲多普勒超聲診斷儀對各組孕婦進(jìn)行腎臟血流動(dòng)力學(xué)檢測。結(jié)果:1 PE組及慢高合并PE組中血BUN、UA明顯高于正常妊娠組和慢高組(P0.05);PE組Scr值明顯高于慢高組、GH組及正常妊娠組,而GFR值明顯低于這3組(P0.05);2 PE組、慢高合并PE組和慢高組3組腎主動(dòng)脈(MRA)及段動(dòng)脈(SRA)的血流峰值加速時(shí)間(AT)明顯高于正常妊娠組(P0.05);GH組僅段動(dòng)脈的血流峰值加速時(shí)間(AT)值高于正常妊娠組,而在主動(dòng)脈此兩組間AT值無差異;5組間MRA及SRA收縮期最大血流速度(Vs)、舒張期末血流速度(Vd)和阻力指數(shù)(RI)均無明顯差異(P0.05)。結(jié)論:妊娠期高血壓病時(shí),子癇前期較慢性高血壓所引起的腎損害更迅速、更嚴(yán)重。用腎臟超聲多普勒測定各級腎動(dòng)脈的AT是早期發(fā)現(xiàn)腎損害的敏感指標(biāo),其聯(lián)合UA及GFR可為臨床早期評價(jià)腎功能、制定治療方案提供可靠依據(jù)。
[Abstract]:Objective: to observe the changes of renal artery hemodynamics in patients with hypertension complicating pregnancy by color Doppler ultrasound. Methods: 40 cases of preeclampsia and 25 cases of chronic hypertension complicated with preeclampsia were selected from Nanjing Maternal and Child Health Hospital of Nanjing Medical University. Serum creatinine was detected in 21 cases of pregnancy complicated with chronic hypertension (slow high pregnancy group, 22 cases of GH group with gestational hypertension) and 48 cases of normal pregnant women (normal pregnancy group). Serum creatinine was detected at 32 ~ 36 weeks of gestation. Scrr, bun, UAA and GFRV were used to detect renal hemodynamics of pregnant women in each group. Results the blood Bun UA was significantly higher in the 1 PE group than in the slow and high PE group, and the glomerular filtration rate (GFRV) was significantly higher than that in the low and high PE group, and the renal hemodynamics of the pregnant women in each group was detected by color Doppler ultrasound. The Scr values in normal pregnancy group and slow high pregnancy group were significantly higher than those in chronic high pregnancy group and normal pregnancy group. The GFR value of the three groups was significantly lower than that of the three groups. The peak acceleration time (ATT) of renal aorta (MRAs) and segmental artery (SRAs) were significantly higher than those of normal pregnancy group (P0.05) and normal pregnancy group (P 0.05), and the ATT value of segmental artery was significantly higher than that of normal pregnancy group. But there was no significant difference in AT value between the two groups. There was no significant difference in peak systolic velocities of MRA and SRA, peak diastolic velocity (VD) and resistance index (RI) between the five groups. Conclusion: during gestational hypertension, there is no significant difference between the two groups (P 0.05). The renal damage caused by preeclampsia is faster and more serious than that caused by chronic hypertension. The detection of AT in renal arteries by renal ultrasound Doppler is a sensitive index for early detection of renal damage. The combination of UA and GFR can be used to evaluate renal function early in clinic. To provide reliable basis for the formulation of treatment plan.
【作者單位】： 南京醫(yī)科大學(xué)附屬南京婦幼保健院產(chǎn)科;
【基金】：國家自然科學(xué)基金-青年科學(xué)基金項(xiàng)目(81200442) 江蘇省衛(wèi)生廳指導(dǎo)性科研課題(Z201309) 南京市衛(wèi)生青年人才培養(yǎng)工程基金(QRX11209)
【分類號】：R714.246

【參考文獻(xiàn)】

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