老年人肾脏相对长度的影响因素及临床意义

目的 分析老年不同阶段健康肾脏的绝对长度和相对长度与年龄、性别、身高的关系，并探讨其临床意义。方法 将303例受检者按年龄段分为3组：40～59岁为老年前组，60～79岁为老年1组，80岁以上为老年2组。采用两维超声方法测量40～88岁正常人的肾脏长径作为绝对长度（ARL），将绝对长度与身高的比值作为相对长度（RRL），分析年龄、性别、身高对肾脏ARL、RRL的影响。结果 ①老年1组、老年2组双侧肾脏的ARL及RRL均较老年前组减小（均P〈0．01）；老年2组双侧肾脏的ARL较老年1组减小（P〈0．01），而RRL较老年1组虽有减小趋势，但差异无显著性（均P〉0．05）。②3组总平均左、右肾脏的ARL男性均高于女性（P〈0．01）；但RRL男女性别间差异无显著性（P〉0．05）。各组组内男性双侧肾脏ARL均高于女性（P〈0．05，P〈0．01）；但RRL男女相比差异无显著性（均P〉0．05）。③166～175cm身高范围双侧肾脏ARL较156-165cm身高范围高（P〈0．01）。以上两个身高范围男女之间差异均无显著性（均P〉0．05）。④各个年龄组左侧肾脏的ARL、RRL显著高于右侧肾脏（P〈0．01）。结论 肾脏长径随年龄增长逐渐减低，并随身高的高低而不同；性别对双侧肾脏绝对长度的影响是间接的。应用RRL表示肾脏长径在消除性别、身高的影响方面较ARL更具有优势。

Clinical significance of relative renal length in elderly

Objective To explore the relationship and clinical significance of absolute renal length (ARL) and relative renal length(RRL) of normal kidney with age,gender,and height.Methods 303 cases were divided into 3 groups according to age: pre-senior group aged from 40-59,senior group 1 aged from 60-79 and senior group 2 aged over 80.Renal diameter in normal cases aged from 40-88 measured by two-dimensional ultrasound was taken as ARL and the ratio of ARL to height was defined as RRL.The effect of age,gender and height on ARL and RRL were analyzed.Results ARL and RRL in senior group 1 and 2 were decreased as compared with those in pre-senior group (P<0.01) and ARL in senior group 2 was decreased as compared with those in senior group 1(P<0.01) but RRL was not significantly decreased as compared with those in senior group 1(P>0.05).ARL of both kidney in each of three groups and the average of total 3 groups were significantly longer in men than in women (P<0.05, P<0.01) but RRL was not significantly different between different genders (P>0.05).ARL of both kidneys was significantly longer in 166-175 cm height range than that in 156-165cm height range (P<0.01),but there was not significantly difference between man and woman (P>0.05).The ARL and RRL of the left kidney in all three groups were significantly greater than those of the right kidney in different groups (P<0.01).Conclusion Renal diameter decreases with age increasing and differs with different height.The influence of gender on ARL is indirect.RRL has more advantages in expressing renal length than ARL because it can eliminate the influence of gender and height.