小儿肾积水病肾血流动力学改变与临床意义

目的了解小儿肾积水肾血流动力学改变与病肾损害程度的关系。方法采用彩色超声多普勒（CDFI）测量小儿肾积水病肾肾主动脉（MRA）、叶间动脉（IRA）及弓状动脉（ARA）的阻力指数（RI），并与健肾测值进行比较；同时行病肾组织学检查分级，然后与病肾RI作相关分析。结果本组共检测78例小儿肾积水，检测发现：病肾各级肾血管（MRA、IRA、ARA）的RI明显升高，与健肾相应动脉RI比较，差异有显著性意义（P〈0．05）；病肾各级血管的RI均随病理分级的增加而递增，且叶间动脉的RI在不同病理分级组间比较，差异均有显著性意义（P〈0．05）；病肾各级血管的RI与病理分级密切正相关，差异有显著性意义（P〈0．05），其中病肾叶间动脉的RI与病理分级相关性最密切，相关系数r=0．715、P〈0．01。结论小儿肾积水病肾各级肾血管的RI明显升高，与病肾损害程度密切正相关，特别是叶间动脉的RI与病肾损害的相关性最密切（P〈0．01）。因此证实利用简单、准确无创的CDFI检测肾血流动力学改变可作为术前判定病肾损害程度的有效方法之一。

Clinical significance of renal hemodynamic evaluation in children with hydronephrosis

Objective To evaluate renal hemodynamic changes in children with hydronephrosis by Color Doppler Flow Image(CDFI).Methods The resistance indexes (RIs) in main renal arteries (MRAs),interlobar renal arteries (IRAs) and arcuate renal arteries (ARAs) were measured in 78 children with hydronephrosis by CDFI.And pathological changes of kidneys were graded in these children.Spearman~ ' s correlation test was used to compare RIs and pathological grades in these kidneys. Results RIs in MRAs,IRAs and ARAs of hydronephrotic kidneys were significant higher than those in healthy kidneys (P< 0.05 ).Moreover,there was significant difference between RIs and pathological grades in these hydronephrotic kidneys,especially in IRAs (r= 0.715 ,P< 0.01 ).Conclusions RI of IRA is an ideal hemodynamic parameter to evaluate renal damage in children with congenital hydronephrosis.