缺氧缺血性脑病新生儿尿大分子碱性磷酸酶的研究  

Significance of urinary high molecular alkaline phosphatase for early diagnosis of renal injury in hypoxic-ischemic encephalopathy newborns

作　　者：任青[1] 温以良[1] 卢宪梅[2] 邓景惕[3] 

机构地区：[1]聊城市人民医院儿科,252000 [2]山东大学齐鲁医院儿科,济南250012 [3]山东大学医学院生化教研室,济南250012

出　　处：《中国小儿急救医学》2007年第5期393-395,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的研究缺氧缺血性脑病(HIE)新生儿尿大分子碱性磷酸酶(HMAP)水平的变化及其早期诊断肾功能损害的价值。方法HIE组包括轻度脑病52例和中重度脑病40例。利用抗HMAP的单克隆抗体,用免疫催化方法检测92例HIE患儿治疗前后及30例正常新生儿(对照组)尿HMAP水平,并测定两组尿β2-微球蛋白(β2-MG)水平。结果HIE组治疗前尿HMAP、β2-MG水平高于治疗后(t=28.15、t=16.12,P<0.01)和对照组(t=11.89、t=12.34,P<0.01),且中重度HIE组尿HMAP高于轻度组(t=2.35,P<0.05);HIE组尿HMAP的异常发生率(85.9%)显著高于β2-MG(65.2%)(χ2=10.62,P<0.01);HIE组尿HMAP与β2-MG呈直线正相关(r=0.56,P<0.01)。结论HIE新生儿大多存在肾功能损害,尿HMAP比β2-MG更灵敏地反映HIE时肾损害的程度,可早期发现HIE新生儿肾损害。Objective To investigate the changes of urinary HMAP in hypoxic-ischemic en- cephalopathy（HIE） newborns and to develop an early diagnostic indicator for HIE renal dysfunction. Methods 52 cases with mild HIE, 40 cases with moderate to severe HIE and 30 cases of normal newborns were en- rolled in this study. A monoclonal antibody immunocatalytic assay method was adapted to detect the level of urinary HMAP before and after treatment in HIE group （92 cases） and in normal control group （30 cases）. The levels of urinary β2-MG in two groups were also detected in the same time. Results The levels of urinary HMAP and β2-MG in HIE group before treatment were higher than those in control group （t = 11.89, t = 12.34, P 〈 0.01 ）, and decreased significantly after treatment （ t = 28.15, t = 16.12, f 〈 0.01 ）. There were no difference between control group and HIE group after treatment （ t = 0.63, t = 0.99, P 〉 0.05 ）. The level of urinary HMAP in moderate to severe HIE group was higher than that in the mild group （ t = 2.35, P 〈 0.05） .The abnormality rate of urinary HAMP. （85.9%） in HIE group was higher than that of urinary β2- MG （65.2 % ） （X2 = 10.62, P 〈 0.01）. Urinary HMAP was positively correlated with β2-MG in HIE group （r = 0.56, P 〈 0.01）. Conclusion Renal injury is common in HIE newborns. Urinary HAMP is a more sen- sitive diagnostic parameter than urinary β2-MG, and may be used for early detection of renal injury in HIE newborns.

关 键 词：婴儿 新生 缺氧缺血性脑病 碱性磷酸酶类 肾功能损害 

分 类 号：R722.1[医药卫生—儿科]