肾积水指数作为胎儿肾积水评价及随访的新方法

Farideh Gharekhanloo
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摘要

背景:本研究旨在比较产前及出生后1、6、12个月,盆腔前后径、实质厚度对肾积水指数(HI)与盆腔前后径、实质厚度对胎儿肾积水的诊断价值。方法:对孕龄> 30周、胎儿疑似肾积水的孕妇进行研究。研究对象采用连续抽样方法收集。在基线和分娩后1、6、12个月用超声测量HI、盆腔AP直径和实质厚度。根据研究设计,研究参与者被分为三组。A组为HI降低和肾积水严重程度升高的病例。B组由HI相对稳定的受试者组成,C组包括HI升高和肾积水严重程度较低的个体。所有的研究测量和分析都是在三个研究组中进行的。结果:结果显示HI与盆腔AP直径呈负相关,而与实质厚度呈正相关。另一方面,在胎儿肾积水的诊断和预后评估中,HI与实质厚度有显著相关性。结论:HI在随访各阶段均与实质厚度和盆腔AP直径评分相关。因此,HI可以很好地替代实质厚度或盆腔AP直径作为肾积水的分级因素。建议进行进一步的研究,以仔细评估HI在肾积水的诊断、预后和临床结果方面的效率。
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Hydronephrosis Index as a New Method for the Evaluation and Follow-up of Fetal Hydronephrosis
Background: The present study was conducted to compare the efficiency of hydronephrosis index (HI) with those of pelvic anteroposterior (AP) diameter and parenchymal thickness in the diagnosis of fetal hydronephrosis in the prenatal period, as well as 1, 6, and 12 months after birth. Methods: This study was conducted on pregnant women with the pregnancy age of > 30 weeks whose fetus was suspected of hydronephrosis. The study participants were collected via the consecutive sampling method. The HI, pelvic AP diameter, and parenchymal thickness were measured at the baseline and 1, 6, and 12 months after delivery using ultrasound. According to the study design, the study participants were divided into three groups. Group A consisted of cases with decreased HI and higher hydronephrosis severity. Group B was composed of subjects with relatively constant HI, and group C entailed individuals with increased HI and lower hydronephrosis severity. All of the study measurements and analyses were performed on the three study groups. Results: The results revealed a negative association between HI and pelvic AP diameter but a positive association with parenchymal thickness. On the other hand, HI showed a significant correlation with parenchymal thickness in the diagnosis and prognostic assessment of fetal hydronephrosis. Conclusion: The HI correlated with parenchymal thickness and pelvic AP diameter scores in all follow-up stages. Accordingly, HI can be concluded to be a good alternative to parenchymal thickness or pelvic AP diameter as a grading factor for hydronephrosis. It is suggested to perform further studies to carefully assess the efficiency of HI in the diagnosis, prognosis, and clinical outcome of hydronephrosis.
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