窒息新生儿肾血流动力学变化与窒息程度关系的研究

目的探讨窒息新生儿肾主动脉、段动脉和叶间动脉血流动力学改变与窒息程度的关系，为临床无创性评价肾功能损害提供诊断依据。方法采用彩色多普勒超声技术分别监测窒息新生儿和正常新生儿出生后24h内的肾主动脉、段动脉和叶间动脉血流动力学参数，即收缩期峰值流速（PSV）、舒张末期流速（EDV）和阻力指数（RI）的变化，同时分析上述参数的变化与新生儿窒息程度的关系。结果与正常组比较，窒息组肾主动脉、段动脉和叶间动脉RI增大，PSV和EDV降低（P〈0．05）；同时轻度窒息与重度窒息患儿的PSV、EDV和RI比较，差异均有统计学意义。结论窒息新生儿肾主动脉、段动脉和叶间动脉血流动力学改变，表现为。肾血流灌注不良、RI增高，且在段动脉和叶间动脉处更为显著；窒息程度与肾内三级动脉的PSV和EDV呈负相关（r=-0．54，-0．79，-0．66，-0．79，-0．79，-0．82，P〈0．05），与RI呈显著正相关关系（r=0．73，0．73，0．80，P〈0．05），窒息程度越高RI增高越明显。

The study of the relationship between renal hemodynamic changes and asphyxia degree in neon-atal asphyxia

Objective To investigate the relationship between main renal artery, segmental artery, interlobar artery hemodynamic changes and asphyxia degree in neonatal asphyxia, and to provide diagnostic information for renal dysfunction evaluation non-invasively in clinic. Methods The main renal artery, segmental artery, interlobar artery hemodynamic parameters （peak systolic velocity PSV, end-diastolic velocity EDV, resistance index RI） changes were monitored by high color Doppler ultrasound in neonates with asphyxia and normal neonates within 24 hours after birth, and the relationship between the results and neonatal asphyxia degree was analyzed. Results Compared with the normal group, the main renal artery, segmental artery, interlobar artery RI was increased in asphyxia group, while the PSV and EDV were decreased （ P 〈 0.05 ） , there was significant difference of PSV, EDV and RI between mild asphyxia group and the severe asphyxia group. Conclusion The appearance of main renal artery, segmental artery, interlobar artery hemodynamics changes in neonatal asphyxia were renal blood flow dysperfusion and RI increase （ segmental artery and interlobar artery show more significant）, there is negative correlation between the asphyxia degree and PSV, EDV of renal arteries （ r = - 0.54, - 0.79, - 0.66, - 0.79, - 0.79, - 0. 82, respectively,P 〈 0.05）, while there is positive correlation between asphyxia and RI （r = 0.73, 0.73, 0.80, respectively, P 〈 0.05）, with the RI increased more obviously, the asphyxia degree is more serious.