中國早產兒及足月新生兒腎臟功能的發育情形

Development of Renal Function in Chinese Premature and Full Term Infants

呂適存(Shis-Tswan Leu) ； 黃金萬(Chin-Wang Hwang) ； 張嘉侃(Jia-Kan Chang)

《Acta Paediatrica Sinica》 24卷4期 (1983/12) Pp. 283-289

摘要

本研究蒐集了127懷孕期自28週至42週的新生兒，以三種不同的研究方式，測定這些嬰兒剛出生時，以及出生後的腎絲球濾過率(GFR)及鈉排出分數(Fractional Excretion of Sodium, FENa)的變化。第一組為研究出生年齡12至24小時的嬰兒。第二組為研究出生年齡滿一週的嬰兒。第三組為研究十個懷孕期為28週的早產兒，連續追蹤其成長過程中腎臟功能的變化。研究結果發現，腎絲球濾過率的發育與懷孕年齡成正比，但是在懷孕期滿36週以前，腎絲球濾過率的增加較不明顯，36週以後才明顯而迅速地增加。出生一週後腎絲球濾過率幾乎為出生時的兩倍，懷孕期28週的早產兒出生後腎絲球濾過率的發育，與各懷孕年齡，剛出生的早產兒腎絲球濾過率相似。至於腎臟對於鈉離子平衡的控制方面。我們發現“鈉排出分數”亦隨年齡作比例性的遞減。嬰兒出生後，“鈉排出分數”的發育情形，較同年齡剛出生嬰兒的腎臟發育成熟較快。

並列摘要

To assess the development of renal function in Chinese newborn infants, 127 clinically well neonates of various gestation age (18 to 42 weeks) were studied for glomerular filtration rate and fractional renal excretion rate of sodium at 12-24 hours of age and one week after birth in all infants and every two week follow up until 14 weeks of age in the ten premature infants of 28 weeks gestation. Timed urine specimens were collected by urinary catheter for two to three hours in each study and blood samples also were collected once at the mid urinary collection period. The results were: the mean glomerular filtration rate was found to be relatively low in infants born priod to 36 weeks' gestational age. A two fold increase in glomerular filtration rate was observed by the first week of life. The postnatal glomerular filtration rate change of the ten premature infants of 28 weeks' gestation age is comparable with the newborn infants of the same gestational age. The percentage of fractional sodium excretion was inversely related to gestational age (r=-0.73, P＜0.01), but the postnatal fractional sodium excretion of premature infants of 28 weeks gestation diminished more rapidly when compared to the newborn infants of same gestational age just after birth (P＜0.01).

並列關鍵字

renal function ； premature infant ； glomerular filtration rate ； fractional excretion of sodium